Do you have an idea you think can move the needle in your field, but you’ve had no traction with NIH or other federal funding agencies? You might consider the Congressionally Directed Medical Research Programs, or CDMRP. Here is a conversation between CDMRP expert Dr. Emilie Clemmens (Artemis Editing) and NIH expert Dr. Meg Bouvier (Bouvier Grant Group).
MB: How did CDMRP get started?
EC: In 1992, frustrated with the pace of research and lack of therapeutic options, a group of breast cancer patient advocates lobbied Congress for faster solutions. CDMRP was born of that frustration. Congress authorized a budget allocation for the U.S. Department of Defense (DoD) under the Defense Appropriations Act that would “foster novel approaches to biomedical research in response to the expressed needs of its stakeholders—the American public, the military, and Congress”. CDMRP funding allocations to date are thus decided by Congress in response to continued lobbying from patient advocates, and patient advocates play a large role in application review.
MB: What does CDMRP fund?
EC: Under the CDMRP umbrella are more than 35 topic-focused programs (e.g., Melanoma Research Program, Spinal Cord Injury Research Program, Hearing Restoration Research Program) and one large subprogram called the Peer Reviewed Medical Research Program, which includes subtopics as varied as eczema to proteomics to suicide prevention. The funding opportunities are crafted by the individual programs, and they can change from year to year such that a program might offer a clinical trial funding opportunity one year but not the next. The amounts allocated per program change, too: individual programs may have funding for FY23 but not FY24, and then return to being funded for FY25.
MB: Those frequent changes must get confusing for potential applicants!
EC: It can certainly be frustrating for grant seekers, but it’s baked in. It seems CDMRP was not meant to become a steady source of funding for the incremental work of labs or institutions. Instead, funding opportunities from CDMRP aim to fill in key gaps that other agencies or industries do not regularly fund, including research on rare or under-resourced conditions and high-risk projects that may not have substantial supporting data.
MB: How does CDMRP differ from NIH?
EC: As the NIH has expanded their approaches to funding, the gap between NIH and CDMRP has narrowed somewhat, yet key differences remain. There are no standing panels for CDMRP peer review; each panel of reviewers is formed anew and is tailored to a particular batch of applications for a specific funding opportunity. Also, CDMRP has a more consistent focus on applied, “bench-to-bedside” research. The project narratives for a CDMRP grant application thus require a stronger emphasis on patient or consumer impact, and many ask for information on how the product or therapeutic will be translated to a clinical environment. Lastly, CDMRP includes patient/consumer advocates on their review panels whose scores for each application are weighted identically to scientific reviewers’ scores. Thus, CDMRP applicants must pay close attention to clearly articulating the potential impact and path to translation for patients.
MB: What would you say are the benefits of this approach to funding biomedical research?
EC: Certainly, the CDMRP approach has its pros and cons. For over 5 years, I managed peer review for CDMRP and was privy to the ways this approach worked well…and ways it didn’t. Though at times some expressed concerns about non-scientific reviewers scoring scientific applications, I found the patient advocate perspective to be a consistent bright spot and critical to the CDMRP mission. These individuals always listened carefully to the recommendations of scientific reviewers and brought to the table a clear-eyed and informed view of the road to clinical translation, awareness of gaps in therapeutic options, and the patient’s view of the potential of a proposed solution. They helped the scientists and clinicians understand how and why a therapy or device might be either unacceptable or a huge boon to the patient community. In my view, this allowed the CDMRP review process to self-select for solutions with the most direct-to-patient clinical benefit, which of course is the mission of this Congressional appropriation.
MB: Under what circumstances might a biomedical researcher consider applying to CDMRP for funding?EC: High-risk/high-reward funding efforts such as Moonshot and ARPA-H are on the rise. CDMRP represents a middle ground between these fast-turnaround funding opportunities and the slow-but-steady dedicated NIH funding stream. It has been facilitating groundbreaking research for over 20 years, and though a relatively small piece of the federal pie for medical research, it holds a key position for peer-reviewed research that fills gaps in medical funding and advances new ideas.
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