State's cancer agency faces an uncertain future
Backers say CPRIT is invaluable; others seek end of taxpayer support.
As it nears the 10th anniversary of its creation by Texas voters, a variety of metrics can be used to gauge the impact of the state agency charged with fighting cancer.
For instance, the Cancer Prevention and Research Institute of Texas — commonly known as CPRIT — has recruited 135 researchers to the state, helped put in motion 108 clinical drug trials and can boast of funding 29 newly minted oncology companies.
But two numbers are starting to loom particularly large for CPRIT: $1 billion and five years.
That’s the amount of taxpayer money CPRIT has left from its original $3 billion authorization to dole out in grants for cancer research, prevention and product development in the state — and how much longer it has to do it. CPRIT hit the two-thirds mark in its spending last month.
The fate of CPRIT, widely considered the nation’s second-largest source of funding for cancer research behind the federal government, is unclear once either its money or time runs out. Some state lawmakers already are laying groundwork to oppose what they view as the likelihood of an eventual push by CPRIT backers for additional taxpayer support so it can continue its mission.
CPRIT Chief Executive Wayne Roberts said the agency is “totally focused on how to spend the last $1 billion” and isn’t engaged in any such planning.
“If the Legislature wants CPRIT to be continued (beyond then), they will find a way to fund it at a level they deem to be appropriate,” Roberts said.
CPRIT was authorized by vot-
ers in 2007 to issue $3 billion in taxpayer-backed bonds — in increments of up to $300 million per year — to pay “for research in Texas to find the causes of and cures for cancer.” The vote came after an emotional campaign that featured famed cyclist and cancer survivor Lance Armstrong traveling across the state in a bus dubbed “Survivor One” to advocate for it.
Cures for various forms of cancer remain elusive a decade after that vote. But progress in devising treatments has been made, and professionals in the health sciences sector say CPRIT rightfully deserves credit for helping fuel the gains and for seeding a growing biomedical industry in Texas.
“To the companies that get CPRIT funding, it is incredibly important,” said Tom Luby, who heads the Texas branch of Johnson & Johnson’s incubator program for startups, known as JLABS, located in the Texas Medical Center in Houston. “There is a high degree of failure (for small oncology companies with unproven treatments), so raising money from traditional sources can be very challenging.”
To date, an estimated 72 percent of CPRIT’s grants have gone to fund research, 18 percent have gone to early stage companies to help get promising drug research off the ground, and 10 percent have gone for cancer prevention programs across the state. According to CPRIT, the funding has triggered $1.37 billion in follow-on investing by venture capital firms, resulted in slightly more than 79,000 direct and indirect Texas jobs and has generated dozens of clinical trials that have enrolled a total of 9,782 patients and helped Texans more easily access state-ofthe-art treatments.
Luby, who worked in Boston with Johnson & Johnson before coming to Texas, also credits CPRIT with making the state internationally known in health sciences circles, saying CPRIT “put Texas on the map as a place to think about doing oncology drug development.”
Still, CPRIT’s reputation hasn’t always been sterling.
Bouncing back from scandal
A high-profile scandal involving the alleged mishandling of $56 million in grants engulfed the agency in 2012. CPRIT’s top three executives at the time resigned, and one was indicted — although he eventually was acquitted after contending he had been made a scapegoat amid the ensuing political storm.
State lawmakers nearly shuttered CPRIT in the wake of the scandal, prohibiting it from issuing grants through much of 2013. The moratorium was lifted after CPRIT’s management structure was overhauled to include more rigorous oversight.
Roberts, who was brought on board to help stabilize CPRIT shortly after the scandal broke and has steered it since then, said the agency has moved past it and has become known for “rigorous peer review” and an “insistence upon maintaining the integrity of our processes.”
State lawmakers appear to agree. They voted during the regular legislative session this year for a bill that, among other things, prolonged CPRIT’s mandate an extra two years by pushing its so-called “sunset” date — a term for the top-to-bottom review that state agencies periodically undergo to determine whether they should continue to exist — out to 2023, from 2021. CPRIT can’t issue grants in the final year before its sunset date.
The move to prolong the life of CPRIT under its existing funding authorization won broad support as something of a feel-good vote that enabled lawmakers to demonstrate support for the fight against cancer. But another proposal, sponsored by state Sen. Charles Schwertner, R-Georgetown, came close to winning approval as well, and it signaled that some might not be inclined to give the agency another extension if it’s accompanied by a request for more taxpayer money.
Schwertner’s bill, which won approval in the Senate but failed to make it onto the House floor, would have required CPRIT to develop a plan to become self-sufficient once its existing taxpayer money runs out.
“I don’t think anyone can argue against or oppose the goal of curing cancer,” Schwertner said. But “whether (paying for research into it) is an essential function of state government, I think is a legitimate question to raise at this time.”
Schwertner, who chairs the Senate’s Health and Human Services Committee, said he expects CPRIT supporters will eventually push for more state money to extend the agency beyond its new sunset date, although there haven’t been any formal proposals to do so yet. He said he opposes such a move.
“It doesn’t rise to a constitutional responsibility (of the state’s), and it certainly doesn’t rise to the highest priority, in my opinion,” he said, given numerous other demands on the state budget.
‘Exactly what they bargained for’
Schwertner’s prediction that an effort eventually will be made to provide CPRIT with additional taxpayer money appears wellfounded.
State Sen. Jane Nelson, who chairs the powerful Senate Finance Committee, voted in favor of his bill this year but has been a longtime advocate for state funding to fight cancer, and she recently told the American-Statesman that she “would certainly support allocating resources to help prevent and eradicate” it given “the human and financial toll this disease takes.” She added that the potential amount is uncertain and will be dependent on many factors.
“We hoped — but never assumed — that royalties and other income would be available to help sustain the institute,” said Nelson, R-Flower Mound, who played a major role in creating CPRIT.
Under Schwertner’s bill, CPRIT would have been required to devise a plan by Dec. 1 next year “to become financially self-sufficient and to continue operations without state funds other than patent royalties and license revenues” from the research and companies it previously has funded once its existing money runs out.
Roberts, however, said CPRIT wasn’t set up to do that.
“If the Legislature had instructed us to design a self-sufficiency portfolio back in 2007, the ratio (among CPRIT’s categories of grants) would be completely flipped,” he said. “In fact, there probably would be no grants for prevention and basic research,” and all the money would go for product development in later-stage companies with a higher likelihood of paying off financially.
The agency’s grants for research and product development contain royalty components for the state, but it has received a total of only about $3.2 million in such payments so far. The figure should grow significantly in coming years, Roberts said, but the amount is uncertain and could be far in the future.
He said his goal in the time remaining before CPRIT’s new sunset date arrives “is to make sure that we are worthy of a discussion (that the agency) be continued” long term.
“I think we are doing exactly what the citizens of Texas intended” when they voted to fund CPRIT a decade ago, Roberts said. “At the end of the day, when we do ride off into the sunset, the Legislature and the citizens of Texas will say they got exactly what they bargained for.”
If CPRIT eventually is abolished, however, executives in the health sciences sector say the void will be felt.
“From our point of view, (CPRIT) has been tremendously important,” said Ken Moseley, senior vice president at Bellicum Pharmaceuticals in Houston, which received $5.7 million from CPRIT in 2011 and about $17 million last year. Bellicum, which has gone from a handful of employees in 2011 to more than 120, is developing cellular immunotherapies for hematological cancers and solid tumors, as well other diseases.
Without CPRIT, Moseley said, “I honestly don’t know where the money would have come from (in 2011) to develop our drug and start the clinical trials in so many sites.”
State lawmakers nearly shuttered CPRIT in the wake of the scandal, prohibiting it from issuing grants through much of 2013.
CPRIT was authorized by voters in 2007 after an emotional campaign that featured famed cyclist and cancer survivor Lance Armstrong as an advocate.