Agency Growth ... And Macro-Budgetary Politics

The Continuing Resolution has started to move through Congress. Absent some unexpected opposition or procedural problems, the bill will become law before October 1 and extend government funding through December 11. As we’ve stressed a number of times, this is all about macro-budgetary politics; it is not about FDA’s performance.However, we do have some notion of what the appropriations committees think about FDA. Notably, the House and the Senate FY 15 appropriations bills both call for greater accountability and oversight of FDA. When these passed out of committee earlier this year, we pointed out that: “as long as the intent is to promote effective and efficient government, we see nothing objectionable in this.”What concerns us, now as then, is having this justified because of the “60% increase in agency funding” over the last 5 years. This is as if: the increased  funds were supporting the same activities (they aren’t); and the agency’s bench is now deep (it isn’t). With new statutory responsibilities, globalization, and increasingly complex science, FDA is still stretched too thin to fully accomplish its mission.As can be seen below, the entire agency has grown over those 5 years ... but the largest shift has been the tripling of user fees. Further, two-thirds of the user fee increase has been the addition of tobacco user fees ($500+ million) and generic drug user fees ($300+ million). For budget authority appropriations, the biggest shift has been for CFSAN ($230 million).Here is what the 5-year analysis looks like:  Note: This week’s Analysis and Commentary was written by Steven Grossman, the deputy executive director of the Alliance for a Stronger FDA.