Senate Confirms Monica Bertagnolli as NIH Director

The Senate confirmed Monica Bertagnolli to lead the National Institutes of Health in a 62-36 vote on Nov. 7. She garnered bipartisan support, with 11 Republicans and all but two members of the Democratic caucus voting in her favor.

As director, Bertagnolli will oversee NIH’s 27 institutes and centers, which have a combined budget of nearly $50 billion. Bertagnolli first came to NIH in the fall of 2022, when she was appointed director of the National Cancer Institute, the largest NIH center. Previously, she was the chief of surgical oncology at the Dana-Farber Brigham Cancer Center and a professor at Harvard Medical School. She also chaired the Alliance for Clinical Trials in Oncology and championed initiatives to improve data infrastructure for clinical research.

NIH has lacked a Senate-confirmed director since Francis Collins stepped down as director at the end of 2021 after holding the role for more than 12 years and through three presidential administrations. NIH Principal Deputy Director Lawrence Tabak has been serving as acting director in the interim. President Biden nominated Bertagnolli in May, more than a year after Collins’ departure.

Her nomination was then stalled by Sen. Bernie Sanders (I-VT), chair of the committee that oversees NIH, who refused to hold a hearing on her nomination until the Biden administration offered a “comprehensive” plan for lowering drug prices. Sanders agreed to move forward in September after the administration struck a deal with pharmaceutical company Regeneron that caps the price of a prospective treatment for COVID-19. The committee held a hearing on Bertagnolli’s nomination on Oct. 18 and voted to advance her nomination a week later.

Sanders pressed Bertagnolli during the hearing to commit to adding a “reasonable pricing” clause to NIH contracts that would limit the cost of drugs developed using federal funds. Bertagnolli said she would work with the committee to ensure the public can access effective treatments, but declined to commit to any specific actions.

Sanders spoke highly of Bertagnolli’s qualifications, but he ultimately broke from the committee’s Democrats to vote against advancing her nomination. “Dr. Monica Bertagnolli is an intelligent and caring person, but has not convinced me that she is prepared to take on the greed and power of the drug companies and health care industry and fight for the transformative changes the NIH needs at this critical moment,” he stated. Sanders also voted against her on the Senate floor.

Bertagnolli garnered the support of the committee’s top Republican, Sen. Bill Cassidy (R-LA), who argues restrictions on drug prices could stifle innovation. “I appreciate her refusal to commit to extreme and counterproductive drug pricing policies like march-in rights and reasonable pricing clauses. ... I expect Dr. Bertagnolli to listen to the NIH experts who have consistently concluded it is not the NIH’s role to weigh in on drug pricing,” he said.