An Assessment of the NIH Women's Health Initiative (1993)

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATION BILL, 1993

JULY 23, 1992.—Committed to the Committee of the Whole House on the State of the Union and ordered to be printed

Mr. NATCHER, from the Committee on Appropriations, submitted the following

REPORT

[To accompany H.R. 5677]

The Committee on Appropriations submits the following report in explanation of the accompanying bill making appropriations for the Departments of Labor, Health and Human Services (except the Food and Drug Administration, Indian Health Service, and the Office of Consumer Affairs), and Education (except Indian Education), Action, the Corporation for Public Broadcasting, the Federal Mediation and Conciliation Service, the Federal Mine Safety and Health Review Commission, the National Commission on Acquired Immune Deficiency Syndrome, the National Commission on Libraries and Information Science, the National Commission on Responsibilities for Financing Postsecondary Education, the National Council on Disability, the National Labor Relations Board, the National Mediation Board, the Occupational Safety and Health Review Commission, the Prospective Payment Assessment Commission, the Physician Payment Review Commission, . . . .

Women's Health lnitiative.–The Women's Health Initiative, a trans-NIH project, was designed to study the major causes of death, disability and frailty in post-menopausal women. The project has three parts: a clinical trial that will investigate new strategies to prevent cancer, cardiovascular disease and osteoporosis; an observational component that will explore new causative factors for these conditions; and a community trial that will test the application of preventive approaches targeting behaviors identified in the “ Healthy People 2000” report. It is estimated that three years will be required to recruit project participants and that nine years of follow-up will be needed to determine the benefits and risks of preventive interventions.

The Committee is concerned by testimony of the Director of NIH that the life-cycle cost estimate for the Women's Health Initiative has increased from $500 million to $619 million. While the Committee has provided $43 million for the 1993 cost of this trial, it believes that the study design and cost estimates should be thoroughly reviewed by an external group with expertise in this area. The NIH is directed to contract with the Institute of Medicine for such a review, which should be completed not later than February 1, 1993. This study should focus on the issue of cost, as well as the issue of whether the study will produce sufficiently reliable results to justify such a massive investment. The cost of this review, estimated at $250,000, should be financed as quickly as possible after this report is issued by reallocating funds within the 1992 allocation for the women's initiative. The Committee understands that the Director may wish to fund other reviews of this type as well as the Institute of Medicine study and has no objection to additional evaluations of such an expensive undertaking.

Minority Health Initiative.–The Minority Health Initiative (MHI) is another major trans-NIH project with the objectives of closing existing minority health gaps . . . .