UVM Cancer Center

Project

UVM Cancer Center
Project Information
Has title	UVM Cancer Center
Has owner	Ed Egan
Has start date
Has deadline date
Has project status	Active
Has project output	Commentary"Commentary" is not in the list (Tool, Data, Content, How-to, Guide) of allowed values for the "Has project output" property.
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Issues

Operations vs. Patients

Issue: Sales remain the same each year from 2025 to 2030, but patients increase by more than 50% from 12k to 19k.

Operations:

Annual impact from FY 2025 to FY 2030
Initial effect $39,357 $0 $39,357 $83,415

Patient spending (table 6)

Table 6: Patients and support people and their spending by year
Year Patients Out-of-state patients Retained in-state patients Support people Total spending (thousands)
FY 2021 8,867 1,507 1,809 3,316 $3,833
FY 2022 9,707 1,650 1,980 3,630 $4,196
FY 2023 10,295 1,750 2,100 3,850 $4,450
FY 2024 11,222 1,908 2,289 4,197 $4,850
FY 2025 12,231 2,079 2,495 4,575 $5,287
FY 2026 13,332 2,266 2,720 4,986 $5,763
FY 2027 14,532 2,470 2,965 5,435 $6,281
FY 2028 15,840 2,693 3,231 5,924 $6,847
FY 2029 17,266 2,935 3,522 6,457 $7,463
FY 2030 18,820 3,199 3,839 7,039 $8,134

Discount Rate

Issue: Discount rate is negative(!), not taken from the stated source, and entirely wrong!

A discount rate of -0.3% was used, which represents the discount rate recommended by the Office of Management
and Budget for 10-year investments. Office of Management and Budget. Circular A-94 Appendix C, http://www.
whitehouse.gov/omb/circulars_a094/a94_appx-c

From https://www.whitehouse.gov/wp-content/uploads/legacy_drupal_files/omb/circulars/A4/a-4.pdf

As a default position, OMB Circular A-94 states that a real discount rate of 7 percent
should be used as a base-case for regulatory analysis. The 7 percent rate is an estimate of the
average before-tax rate of return to private capital in the U.S. economy.  ...
If we take the
rate that the average saver uses to discount future consumption as our measure of the social rate
of time preference, then the real rate of return on long-term government debt may provide a fair
approximation. Over the last thirty years, this rate has averaged around 3 percent in real terms on
a pre-tax basis. ...
For regulatory analysis, you should provide estimates of net benefits using both 3 percent
and 7 percent. ...
If you are uncertain about the nature of the
opportunity cost, then you should present benefit and cost estimates using a higher discount rate
as a further sensitivity analysis as well as using the 3 and 7 percent rates. 

From https://fred.stlouisfed.org/series/DGS10

Market Yield on U.S. Treasury Securities at 10-Year Constant Maturity, Quoted on an Investment Basis (DGS10)
Observation: 2023-03-02: 4.08

Research funding

Issues:

• Estimating multiplier effects (in-state), especially for non-labor, when there is no in-state activity outside of UVM!
  • In particular, there are no externalities to clinical trials or federal grants because there is no one else in the state to benefit from spillovers.
• The Cancer Center proposes making UVM a 90th percentile recipient of cancer grants and accounting for perhaps 25% of all UVM NIH grants (15% of funding).

From FY 2021 to FY 2030, the research spending will add $161.6 million in
labor income and $30.7 million in non-labor income. This equates to $192.3 million in
total added income for the Vermont economy.

To fund this research spending, UVMCC will receive $21.8 million in revenue. Half a
million will come from patient care clinical trials, $15 million from federal grants, and
$6.2 million from philanthropy and other sources of funding.

Students

Issue: Students are somewhat double-counted. Their economic benefit (while students) is already contained in the labor spend from operations or the grant income.

The spending of these relocated and retained students can be attributed to UVMCC.
The average costs for students appear in Table 9, equal to $15,620 per student. Note that
this table excludes expenses for books and supplies, since many of these monies are
already reflected in the operations spending impact discussed in the previous section

NCI Data

Files:

• The SQL is E:\projects\grants\NIH\LoadNIH.sql
• The images, analysis, and reference files are in Z:\projects\Vermont\Cancer Center

The number of National Cancer Institute grants received in Vermont follows a familiar pattern: It oscillates around a modest value from the start of the data in 1987 before declining precipitously at some point between 2000 and 2010. For the NCI data, this decline happened around 2005. The mean value in the late 20th century was around 20 (i.e., ~18 for UVM and ~2 for other Vermont), and the mean following the decline is around 8. Moreover, before the collapse, a few grants were received by organizations other than UVM, but only UVM received NCI grants after 2012.

The NCI doesn't provide amounts for grants prior to 2012. When there are amounts available, only UVM received grants, and the grant amounts followed the same trend as the grant numbers. The mean grant amount is around $850,000.

So, for the Cancer Center to achieve its goal of $15m/yr in grants, it would need around 18 grants per year. There were 631 organizations receiving funding from the NCI in 2021; an organization with 18 grants per year is around the 85th percentile. Of course, not all NCI grants will likely accrue to the Cancer Center. The Cancer Center would, therefore likely have to add between 10 and 15 grants per year to UVM's totals.

Below is a list of institutions that UVM would have to be competitive in terms of NCI grants to achieve its goals:

UNIVERSITY OF ROCHESTER
JACKSON LABORATORY
UNIVERSITY OF NEW MEXICO
STATE UNIVERSITY NEW YORK STONY BROOK
UNIVERSITY OF IOWA
PENNSYLVANIA STATE UNIV HERSHEY MED CTR
THE MILKEN INSTITUTE SCHOOL OF PUBLIC HEALTH AT THE GEORGE WASHINGTON UNIVERSITY
BROAD INSTITUTE, INC.

NIH Grant Data

I had Federal Grant Data from the NIH to hand from another project, updated to 2021 (see Vermont Science and Technology Plan). It shows that:

• UVM and non-UVM NIH grants combined were at record low levels in 2017 and were at their second-lowest level on record in 2021.
• UVM averaged around 150 NIH grants per year until about 2010. From 2011 to the present, it has averaged closer to 100 grants per year.
• The total value of NIH grants to UVM also fell in 2011 but has increased somewhat in the last 5 years.
• Non-UVM NIH grants experienced a boom from 2006 to 2016 but are now back to near-zero levels.

Assuming the Cancer Center meets its goals, it would add somewhere between 10 and perhaps 15 new grants (depending on how many cancer grants will accrue to researchers outside of the center) for a total between $8 and $12m additional dollars. This suggests that the Cancer Center will need to:

• Increase UVM's number of NIH grants by around 12% and the amount of its NIH funding by around 14% each year.
• Account for around 23% of UVM's NIH grants and around 15% of its NIH funding each year.