The Directors: Candace Johnson and Jonathan Friedberg on getting through the NCI scale-down, payment woes

Directors of two neighboring cancer centers in Upstate New York will face challenges but “we’ll get through it.”

Candace Johnson leads America’s oldest cancer research center and Jonathan Friedberg leads the newest NCI-designated center. Their catchment areas are contiguous, their faculties and staff work seamlessly together, and together their institutions embody the culture of NCI-designated cancer centers. 

What worries them the most? It’s a combination of threats coming from Washington. 

“I think what’s a challenge is all of these things coming together,” said Jonathan W. Friedberg, director of the University of Rochester Wilmot Cancer Institute, who holds the Samuel E. Durand Chair in Medicine at the Department of Medicine. 

“In and of itself, could we weather an indirect cost adjustment? Probably,” Friedberg said. “But if that happens at the same time as a Medicaid cut? For us, 340B is a major, major way that our medical center receives funding. If that is interrupted? And site neutrality as far as places where care is delivered and how that’s reimbursed?”

What about the nearly 40% cut in the NCI budget that is being proposed by the Trump administration? 

“Yes, that could be significant too. I mean, I think that I’m a little more optimistic in general. I mean a very optimistic person in how I try to handle these things,” said Candace S. Johnson, president & CEO of Roswell Park Comprehensive Cancer Center, who also holds the M&T Bank Presidential Chair in Leadership.

With widespread support for cancer research, NCI funding is bound to bounce back in due course, Johnson said.

“Everyone supports cancer research, no matter who you talk to, on what side of the aisle—everybody, because it affects all of us. Everybody wants to be able to continue funding for the NCI,” Johnson said. “And so, I’m hopeful that this is all going to come back to some of these levels where it makes it at least achievable to get a grant.”

Steven T. Rosen, the Ted Schwartz Family Distinguished Chair in Hematologic Malignancies at City of Hope, a discussant on this episode of The Directors, said current challenges come at a time when science is being translated into patient benefits. 

As an expert in lymphomas and chronic leukemias, two decades ago, Rosen expected that half of his patients would die of their diseases. 

This is no longer the case.

Progress like what Rosen has seen in the clinic requires resources, he said.

“Resources are needed—there’s no question,” said Rosen, who served as director of Northwestern’s Robert H. Lurie Comprehensive Cancer Center for 24 years. “And people could argue about how much should be indirects versus directs, but every dollar that would be cut from the NIH or from other funding sources will be detrimental.

“There’s no way of getting around that.”