Rees CA, Monuteaux MC, Herdell V, et al. - According to this cross-sectional analysis, national Institutes of Health (NIH) funding for pediatric research was found to be connected with pediatric disease burden in the US, with varying degrees of association depending on the disease metric used. Certain conditions were significantly overfunded and underfunded. Ongoing study of pediatric funding patterns using a complementary set of disease metrics may assist in informing and prioritizing pediatric research funding.

• This study looked at 14,060 disease-specific pediatric grants awarded by the NIH in the US between 2015 and 2018.

• The annual funding ranged from $0 to $382,849,631 for disease categories.

• Pediatric disability-adjusted life-years (DALYs), deaths, years lived with disability, and years of life lost were all associated with funding for pediatric research.

• There was also a link between funding and hospital-based metrics such as hospital days, number of hospital admissions, and hospital expenses.

• Eight disease categories received greater than $500 million more than expected levels in terms of DALYs, whereas 5 disease categories were funded more than $50 million less than predicted levels.

• Congenital birth defects, endocrine, metabolic, blood, and immune disorders, and HIV/AIDS were the most overfunded categories in terms of DALYs and hospital days, based on predicted levels of funding.

• The conditions identified as the most underfunded changed depending on whether DALYs or hospital days were used to calculate future spending levels.