Journal article
Recent trends and structural patterns in NIH pediatric research funding, 2015-2024
Pediatric research
08/13/2026
DOI: 10.1038/s41390-026-05379-5
PMID: 42595824
Abstract
National Institutes of Health (NIH) pediatric research funding has persistently lagged behind children's share of the US population and disease burden. This study examined trends in NIH pediatric research expenditures, funding distribution across NIH components, and classification accuracy of the NIH Research, Condition, and Disease Categorization (RCDC)'s system for identifying pediatric research.
We conducted a repeated cross-sectional analysis of RCDC, NIH Office of Budget, and NIH RePORTER data from fiscal years (FY) 2015-2024. Expenditures were inflation-adjusted using the Biomedical Research and Development Price Index (BRDPI). A stratified random audit of 200 RCDC Pediatric-category projects assessed classification accuracy.
NIH research expenditures grew 62% nominally (FY2015: $28.5 billion; FY2024: $46.1 billion), but only 26% in inflation-adjusted dollars. Pediatric research consistently comprised approximately 13% of NIH nonadministrative expenditures, despite children <18 years-old constituting 22% of the US population. Five institutes accounted for 57% of pediatric research expenditures. The audit identified a 6% misclassification rate, clustering around maternal health studies lacking pediatric outcomes.
NIH pediatric research funding remained proportionally stagnant, rising passively with the NIH budget rather than reflecting deliberate prioritization. Strengthening pediatric and life-course research may require more coordinated trans-NIH prioritization.
In nominal dollars, pediatric research funding at the NIH rose from $3.5 billion in FY2015 to $6.2 billion in FY2024; however, adjusted for inflation, the level of funding plateaued from FY2020 to FY2024. As a proportion of NIH nonadministrative expenditures, pediatric research accounted for approximately 13% across FY2015-FY2024. Although NICHD devoted 58-60% of its research funding to pediatric studies, it accounted for just 17% of all pediatric research funding. Every NIH component funded some amount of pediatric research, but the NIH lacks a coordinated trans-NIH strategy for pediatric research prioritization and oversight.
Details
- Title: Subtitle
- Recent trends and structural patterns in NIH pediatric research funding, 2015-2024
- Creators
- Christopher B Forrest - Children's Hospital of PhiladelphiaLauren J Koenigsberg - Children's Hospital of PhiladelphiaDavid C Schwebel - University of IowaAlexander G Bassuk - University of IowaPhyllis A Dennery - Brown UniversityGlenn Flores - University of MiamiKristy O Murray - Emory UniversityUdara Perera - National Center for Health ResearchFrederick P Rivara - University of WashingtonLeah C Kottyan - Cincinnati Children's Hospital Medical Center
- Resource Type
- Journal article
- Publication Details
- Pediatric research
- DOI
- 10.1038/s41390-026-05379-5
- PMID
- 42595824
- NLM abbreviation
- Pediatr Res
- ISSN
- 1530-0447
- eISSN
- 1530-0447
- Publisher
- Springer Nature
- Grant note
- Children's Hospital of Philadelphia
Analysis of the data in this manuscript was supported by institutional funds from the Children's Hospital of Philadelphia. The funder for the data analysis portion of this work had no role in the design, conduct, analysis, or dissemination of the work reported in this manuscript.
- Language
- English
- Electronic publication date
- 08/13/2026
- Academic Unit
- Neurology; Research Administration; Stead Family Department of Pediatrics; Psychological and Brain Sciences; Iowa Neuroscience Institute; Neurology (Pediatrics)
- Record Identifier
- 9985218397602771
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