Senate confirms Monica Bertagnolli as NIH director

Longtime cancer doctor Monica Bertagnolli is finally heading to the National Institutes of Health director’s office after a nearly two-year effort to install a permanent leader atop the $48 billion science agency.

The Senate voted 62-36 Tuesday to confirm her nomination, giving the White House clearance to officially name Bertagnolli the institute’s director, the second woman ever to fill the role. The move comes nearly two years after veteran NIH director Francis Collins retired, igniting a nationwide search for someone to oversee the campus’ 27 institutes and navigate the increasingly political landscape around the agency’s research.

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She’ll also assume the role weeks before a potential government shutdown over budget disputes that could freeze a range of NIH work and bring the first funding cuts in years for an agency that typically sees bipartisan support in Washington.

It was a long search for a director. After multiple close calls and potential nominees, President Biden this May named Bertagnolli, the National Cancer Institute director, as his pick. She had started as NCI director less than eight months earlier, and announced her own diagnosis, for early-stage breast cancer, roughly two months into her tenure.

Her confirmation was swiftly applauded by cancer research advocates and physicians, with the vote ultimately drawing support from Republicans as well, including Sens. Bill Cassidy (R-La.) and Susan Collins (R-Maine), the highest-ranking GOP members of health committees.

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“Dr. Bertagnolli is a physician scientist and a patient herself, and deeply understands the intricacies and personal impact of biomedical research,” Ellen Sigal, chair and founder of Friends of Cancer Research, said in a statement to STAT. “The Senate’s strong bipartisan confirmation vote is a testament to her and her ability to lead the NIH.”

However, some progressive senators opposed advancing Bertagnolli’s nomination. HELP Committee Chair Bernie Sanders (I-Vt.) stalled her confirmation process by refusing to hold a hearing until federal health officials pledged to broker more deals with pharmaceutical companies that included so-called reasonable pricing controls. He scheduled her October hearing only after the Health and Human Services Department announced a Covid-19 treatment agreement with Regeneron that included such a clause.

Yet he could not get Bertagnolli to commit to broadly applying those requirements to partnerships with drugmakers who use NIH research, and ultimately opposed her confirmation.

“At this very difficult moment for American health care, we need an NIH director who is prepared to take on the greed of the pharmaceutical industry and use every tool at their disposal to substantially lower the outrageous cost of prescription drugs,” he said in floor remarks Tuesday before the vote. “The status quo is not working. We need fundamental changes in the way that the NIH addresses the crisis of the high cost of prescription drugs.”

Pennsylvania Democrat Sen. John Fetterman also voted no on Tuesday, citing similar concerns that she would not address high drug costs.

Before joining the NCI, Bertagnolli led Dana-Farber Cancer Institute’s surgical oncology unit. She sought cancer treatment at her former hospital and told senators recently that she is in recovery. She also previously served as president of the American Society of Clinical Oncology and was elected a National Academy of Medicine Fellow last year.

Much of Bertagnolli’s focus at NCI and in her previous work has centered around diversifying clinical trials and the workforce treating patients.

The agency “is in good hands,” with Bertagnolli, who brings “a unique combination of basic, clinical and medical experience grounded in personal experience,” said Sudip Parikh, CEO of the American Association for the Advancement of Science.

Deputy NIH Director Lawrence Tabak has served as acting director since Collins’ departure in December 2021.