Who’s afraid of big government? Texas’ public push into cancer research pays off

Sunday, November 3, 2019

Texas isn’t generally considered a national leader in research and development, despite having some renowned institutions and a string of Nobel Prize winners.

But reality is ahead of perception, and the trend has been improving steadily. Now voters have a chance to keep the momentum going.

On Tuesday, they’ll consider a proposition to approve another $3 billion for cancer research, following up on the commitment they made a dozen years ago.

Since then, the Cancer Prevention & Research Institute of Texas, known as CPRIT, has become the nation’s second-largest public funder of cancer research, behind only the National Cancer Institute.

Last year, the federal agency awarded $249 million for research in Texas, and CPRIT roughly doubles that annual spending. Since 2009, CPRIT has awarded 1,500 grants worth over $2.4 billion.

That money helped recruit 181 researchers and labs, including dozens of scholars from states with bigger research bounties. It helped generate medical breakthroughs and startup successes, and paid for prevention screenings that detected over 3,600 cancers.

One more important return on investment: The $2.4 billion given to researchers and companies has brought in $4.2 billion from other sources.

“CPRIT’s been an important engine in the state and North Texas,” said Dr. Daniel Podolsky, president of UT Southwestern Medical Center in Dallas.

The hometown leader in R&D has been the biggest beneficiary. Since 2009, it has won 322 awards worth over $461 million, according to CPRIT.

That’s slightly more than the esteemed University of Texas M.D. Anderson Cancer Center in Houston.

“What’s that translate into in terms of impact?” Podolsky said last month. “It’s helped us recruit over 60 faculty from around the country and compete for real talent, which in the end is the lifeblood of any institution.”

A $10 million grant helped UT Southwestern recruit Sean Morrison from the University of Michigan in 2011. He studies the nexus between stem cells and cancer cells, and directs the Children’s Medical Center Research Institute.

In 2011, a $10 million CPRIT grant helped M.D. Anderson bring in Jim Allison from Memorial Sloan-Kettering in New York. Last year, Allison won the Nobel Prize for his work on a protein that behaves like a brake on the immune system.

Importing such talent is a way for Texas to accelerate its R&D and close the gap with the country’s research leaders. Texas institutions poached more than half of the CPRIT scholars from California, Massachusetts and New York — the top-ranked states in federal research from four key agencies.

Texas was No. 7 on that list for 2018, but it brought in half as much as the more established rivals.

Still, the progress under CPRIT has been meaningful. Two more institutions, including UT Southwestern, have been named “comprehensive cancer centers,” the highest designation by the National Cancer Institute.

Almost 20,000 patients have participated in 132 clinical trials, and $250 million funded 226 prevention programs, according to the agency.

Thirty-six companies, which started, expanded or relocated to Texas, received $437 million from CPRIT. That seed money brought in $3 billion in follow-on funding, a 7-to-1 return, the agency said.

CPRIT said these efforts led to over 10,100 permanent jobs last year and $58 million in state and local taxes. Almost $4 million in patent royalties have been generated for the state.

Is all this worth $3 billion in public money — and another $3 billion to come?

Vivian Ho, a health economist at Rice University, was skeptical. She opposed the initial proposition, figuring that it wasn’t enough money to move the needle and that the feds would handle it. She changed her mind.

“Seeing it play out and thinking about Texas politics, it was a good idea then — and it’s a good idea to double down now,” Ho said.

Texas has a comparative advantage in cancer research, thanks to M.D. Anderson and UT Southwestern. She said that’s something to capitalize on, both to bring excellent care to residents and to boost the economy.

Cancer dominated research spending at Texas’ health-related institutions last year. It topped $1.2 billion, according to the Texas Higher Education Coordinating Board. That was roughly 20 times more than the next-closest specialties: cardiovascular, aging and mental health.

Even without CPRIT, cancer research would still be far and away the leader. That’s a reflection of the number of talented researchers in the state. Deepening that expertise is a good strategy with spin-off potential, said Eleanor Dehoney, vice president of policy and advocacy at Research America, a group that advocates for more research funding.

“You’re definitely building on your strengths,” Dehoney said. “But you’re also building an infrastructure — and talent in one arena attracts talent in another.”

In 2007, over 61% of Texas voters backed the proposal to create and fund CPRIT. In 2012, the agency had a scandal over awarding grants without proper review, which led to the resignation of the chief scientific officer and indictment of another executive, who was acquitted.

Oversight of the organization was restructured, and that appears to have satisfied lawmakers. They overwhelmingly supported putting Proposition 6 on the ballot.

Some object to using bonds, suggesting the Legislature could fund CPRIT every two years and avoid interest costs. But economic cycles and politics could put that money at risk, and investments in research can take a decade to pay off.

Others said the state could help more people, especially children, by spending the money elsewhere. But Ho doesn’t see that happening. Lawmakers have refused to expand Medicaid, for instance, even though it would bring billions in health benefits to the working poor.

“What things are they willing to fund?” Ho said of Texas lawmakers. “At least with cancer research, they’re willing to let voters say they’ll pay extra.”

Media Contacts

Robert Shalett
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571-482-2737

Without continued support for health research, many of the most promising young scientists, their ideas and a myriad of potentially life-changing scientific breakthroughs will vanish into oblivion.
Paul Marinec, PhD; University of California San Francisco