Congressionally Directed Medical Research Programs: Background and Issues for Congress

Congressionally Directed Medical Research Programs: Background and Issues for Congress

Congressionally Directed Medical Research
July 13, 2022
Programs: Background and Issues for Congress Bryce H. P. Mendez
Since fiscal year (FY) 1992, Congress has appropriated funds to the Department of
Analyst in Defense Health
Defense (DOD) explicitly for use in conducting medical research. This appropriation is
Care Policy
also known as the Congressionally Directed Medical Research Programs (CDMRP). The

U.S. Army Medical Research and Development Command (MRDC), in coordination
with the Defense Health Agency, administers the program using a competitive grant

process. CDMRP funding is to be used only for medical research on congressionally identified medical research
topics (e.g., breast cancer, gulf war illness, cancer, or other medical conditions). Both intramural (DOD) and
extramural (non-DOD) researchers are eligible to apply for CDMRP funding, as long as applicants meet the
requirements and criteria established by CDMRP grant administrators.
DOD does not request CDMRP funding as part of its annual budget request process. Instead, Congress inserts
CDMRP funding in the annual DOD appropriations act, typically under the Research, Development, Test, and
Evaluation (RDTE) budget activities of the Defense Health Program (DHP) and Department of the Army
accounts. The explanatory statement accompanying the annual DOD appropriations act typically provides further
congressional direction on how DOD is to spend CDMRP funding. Only Members of Congress may submit such
requests for specific medical research topics and funding amounts to be included in CDMRP appropriations. A
request is typically of interest to a Member or his/her constituency; requests may also be submitted on behalf of
an advocacy organization. In general, the House and Senate use similar processes to solicit, receive, and consider
Members’ annual funding requests for CDMRP.
Since its inception, annual congressional appropriations for CDMRP have grown from $25 million in FY1992 to
$1.55 billion in FY2022. In recent years, CDMRP funding has accounted for at least half of the DHP RDT&E
account. CDMRP has supported more than 50 unique research programs or topics. Cumulatively, the largest
CDMRP research topics are the
 Breast Cancer Research Program ($4.09 billion);
 Peer-Reviewed Medical Research Program (PRMRP; $3.45 billion);
 Prostate Cancer Research Program ($2.15 billion);
 Psychological Health/Traumatic Brain Injury Research Program ($1.61 billion); and
 Peer-Reviewed Cancer Research Program (PRCRP; $784.80 million).
During the annual appropriations process, CDMRP presents certain issues that may be of interest to Congress,
such as
 historical growth in DOD medical research spending;
 military relevancy of CDMRP topics;
 research continuity challenges;
 duplication and overlap with other federal research entities; and
 military health system reform.

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Contents
Introduction ..................................................................................................................................... 1
Background ..................................................................................................................................... 1
Origin of CDMRP ..................................................................................................................... 2
Annual Congressional Appropriations ............................................................................................ 3
Congressional Request Processes.............................................................................................. 3
House Appropriations Process for CDMRP Funding Requests .......................................... 4
Senate Appropriations Process for CDMRP Funding Requests .......................................... 4
Considering Member Requests ........................................................................................... 5
Congressional Ban on Earmarks ............................................................................................... 5
Administration of CDMRP Funding ............................................................................................... 6
DOD Program Administration .................................................................................................. 6
CDMRP Grants ................................................................................................................... 6
Historical Funding Trends................................................................................................... 8
CDMRP Research Programs ............................................................................................... 9
Issues for Congress ........................................................................................................................ 10
DHP RDT&E Cost Growth ..................................................................................................... 10
Military Relevance .................................................................................................................. 12
Research Continuity ................................................................................................................ 13
Duplication and Overlap with other Federal Research Entities .............................................. 14
Military Health System Reform .............................................................................................. 15
Congressional Outlook .................................................................................................................. 16

Figures
Figure 1. DOD Governance of CDMRP ......................................................................................... 6
Figure 2. CDMRP Grant Process .................................................................................................... 8
Figure 3. Congressional Appropriations for CDMRP, FY1992-FY2022 ........................................ 9
Figure 4. DHP RDT&E and CDMRP Funding Proportions and Amounts ..................................... 11

Figure B-1. CDMRP Funding Assigned to the DHP RDT&E Budget Activity ............................ 18
Figure C-1. CDMRP Funding Assigned to the Army RDT&E Budget Activity ........................... 19
Figure D-1. Example of a Call for Member Funding Requests ..................................................... 20
Figure E-1. CDMRP Programs and Cumulative Funding ............................................................. 21
Figure F-1. PRMRP Eligible Research Topics .............................................................................. 22
Figure F-2. PRMRP Eligible Research Topics (Continued) .......................................................... 23
Figure G-1. PRCRP Eligible Research Topics .............................................................................. 24

Appendixes
Appendix A. Acronyms ................................................................................................................. 17
Appendix B. CDMRP Funding – DHP RDT&E Budget Activity ................................................. 18
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Appendix C. CDMRP Funding – Army RDT&E Budget Activity ............................................... 19
Appendix D. Example of a Call for Member Funding Requests, House of Representatives ........ 20
Appendix E. CDMRP Programs and Cumulative Funding, FY1992-FY2022 .............................. 21
Appendix F. PRMRP Eligible Research Topics, FY1999-FY2022 ............................................... 22
Appendix G. PRCRP Eligible Research Topics, FY2009-FY2022 ............................................... 24

Contacts
Author Information ........................................................................................................................ 25

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Introduction
The Department of Defense (DOD) receives annual appropriations explicitly for the conduct of
medical research on topics specifically identified by Congress; these funds are administered as
the Congressionally Directed Medical Research Programs (CDMRP). Since its establishment in
fiscal year (FY) 1992, Congress has continued to appropriate annual funding for CDMRP, which
has managed and funded numerous DOD medical research programs and projects.
This report provides an overview of CDMRP and describes how Congress manages CDMRP
funding requests and assigns annual appropriations. It also reviews how DOD administers
CDMRP funding and presents several potential issues for Congress, including medical cost
growth, military relevancy of CDMRP topics, research continuity challenges, Military Health
System (MHS) reform, congressional earmarks, and unauthorized appropriations.
Appendix A provides a list of acronyms used throughout this report.
Background
Under Title 10, Section 2358 of the U.S. Code (U.S.C.), DOD administers a wide-range of
research and development (R&D) programs. DOD receives the largest amount of federal funding
for R&D, which primarily focuses on “basic research, applied research, advanced research, and
development projects” that are
 necessary to the responsibilities of such Secretary’s department in the field of
research and development; and either
 relate to weapon systems and other military needs; or
 are of potential interest to the DOD.1
In general, DOD conducts medical research based on the “needs of the National Defense Strategy
and the Joint Capabilities Integration and Development System.”2 Numerous DOD components
perform or sponsor medical research activities, including the Defense Health Agency (DHA), the
military departments, Defense Advanced Research Projects Agency, and the Defense Threat
Reduction Agency. DOD organizes its medical research efforts under the following focus areas:
 biomedical informatics and health information systems and technology;
 clinical and rehabilitative medicine;
 combat casualty care;
 medical chemical and biological defense;
 medical radiological defense;

1 10 U.S.C. §2358. In FY2022, DOD requested $62.8 billion total R&D. For more DOD research and development
programs and historical funding amounts, see CRS Report R46869, Federal Research and Development (R&D)
Funding: FY2022, coordinated by John F. Sargent Jr.; and CRS Report R44711, Department of Defense Research,
Development, Test, and Evaluation (RDT&E): Appropriations Structure, by John F. Sargent Jr.
2 DOD, Department of Defense Strategic Medical Research Plan, p. 6, https://health.mil/Reference-Center/
Congressional-Testimonies/2019/04/08/Strategic-Medical-Research-Plan. For more on the National Defense Strategy,
see CRS Report R45349, The 2018 National Defense Strategy: Fact Sheet, by Kathleen J. McInnis. For more on the
Joint Capabilities Integration and Development System, see pp. 3-4 of CRS Report RL34026, Defense Acquisitions:
How DOD Acquires Weapon Systems and Recent Efforts to Reform the Process, by Heidi M. Peters.
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 military infectious diseases; and
 military operational medicine.3
To reduce unnecessary duplication of work, DOD components participate in the Armed Services
Biomedical Research Evaluation and Management (ASBREM) community of interest.4 The
ASBREM serves as the primary coordination body for DOD’s medical research community,
while individual DOD components resource and perform (or sponsor) medical research projects.
DOD generally has the second-largest departmental expenditures on medical research, after the
National Institutes of Health (NIH), U.S. Department of Health and Human Services.5 Each year,
DOD submits its budget request for medical R&D activities and projects in accordance with its
statutory mission. Congress evaluates, adjusts, and appropriates such funds. Congress may also
include additional funding for R&D activities that DOD may or may not have requested.
Origin of CDMRP
In the early 1990s, women’s health issues and the inclusion of women in federal medical research
were rising topics in the United States and attracted the attention of some Members of Congress.6
At the time, certain advocacy groups (e.g., National Breast Cancer Coalition, American Cancer
Society, Susan G. Komen Foundation) also lobbied Congress to increase federal spending on
breast cancer research, a condition most prevalent among women.7 In FY1992, Congress
accordingly appropriated $25 million to DOD to use specifically for breast cancer research.8
In considering appropriations for FY1993, Members’ interest in increasing federal funding for
breast cancer research remained. Some Members explored redirecting “$29 billion in unobligated
funds from prior years for the development of weapons systems planned before the collapse of
the Soviet Union in 1991” to domestic programs such as the National Cancer Institute for breast
cancer research activities.9 However, certain provisions in the Budget Enforcement Act of 1990

3 DOD, Department of Defense Strategic Medical Research Plan, p. 6.
4 The role of the Armed Services Biomedical Research Evaluation and Management (ASBREM) is to “promote the
coordination and synergy of the DoD biomedical R&D efforts to provide medical products and information” required
to protect and sustain servicemembers. For more on the ASBREM, see Department of Defense (DOD), Integrated DoD
Biomedical Research and Development Strategy, Medical Innovation for the Future Force, December 2017, p. iii,
https://defenseinnovationmarketplace.dtic.mil/wp-content/uploads/2018/04/
ASBREM_Integrated_RD_Strategy_2017.pdf.
5 Research America, U.S. Investments in Medical and Health Research and Development, 2016-2020, January 2022, p.
8, https://www.researchamerica.org/sites/default/files/Publications/Research%21America-
Investment%20Report.Final.January%202022.pdf.
6 See Richard M. Steingart, Milton Packer, and Peggy Hamm, et al., “Sex Differences in the Management of Coronary
Artery Disease,” New England Journal of Medicine, vol. 325 (July 25, 1991), pp. 226-230; “Effective Lobbying
Increases U.S. Funds for Breast Cancer Research,” New York Times, October 19, 1992, p. A15; and Institute of
Medicine, Strategies to Leverage Research Funding: Guiding DOD’s Peer Reviewed Medical Research Programs,
2004, pp. 13-15, https://www.nap.edu/catalog/11089/strategies-to-leverage-research-funding-guiding-dods-peer-
reviewed-medical.
7 See “Effective Lobbying Increases U.S. Funds for Breast Cancer Research,” New York Times, October 19, 1992, p.
A15; and U.S. Centers for Disease Control and Prevention, “Deaths from Breast Cancer—United States, 1991,”
Morbidity and Mortality Weekly Report, April 22, 1994, pp. 279-281, https://www.cdc.gov/mmwr/preview/mmwrhtml/
00026281.htm#:~:text=In%201991%2C%2043%2C583%20women%20died,for%20white%20women%20(26.8).
8 U.S. Congress, House Committee on Appropriations, Department of Defense Appropriations Act, 1992, Conference
report accompanying H.R. 2521, 102nd Cong., 1st sess., November 18, 1991, H.Rept. 102-328, p. 134.
9 See Institute of Medicine, Strategies to Leverage Research Funding: Guiding DOD’s Peer Reviewed Medical
Research Programs, 2004, p. 14; and Sen. Arlen Specter, “Departments of Labor-HHS-Education Appropriations Act,
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(P.L. 101-508) prohibited breaches in established discretionary spending categories and
constrained such transfers from defense to domestic accounts (or vice-versa). 10 In FY1993,
Congress appropriated $210 million to DOD for breast cancer research, required such research to
be “peer reviewed,” and designated the Department of the Army as the executive agent of the
“breast cancer research program.”11 DOD later began the practice of referring to the unrequested
funds for use on specified medical research topics as CDMRP. Typically, CDMRP funded-topics
are in addition to already established DOD medical research focus areas.
Annual Congressional Appropriations
DOD does not request funding for CDMRP as part of the President’s annual budget submission.
Instead, Congress inserts CDMRP funding into the Defense Health Program (DHP) account of
the annual defense appropriations bill. Typically, CDMRP funding is organized under the
Research, Development, Test, and Evaluation (RDT&E) budget activity and assigned to the
funding line for Undistributed Medical Research (see Appendix B). While the DHP account
encompasses the bulk amount of CDMRP funding, Congress may also assign such funding to
other defense accounts. Historically, the Army RDT&E budget activity has included several
CDMRP funding lines, such as “peer-reviewed neurotoxin exposure treatment” as related to
Parkinson’s disease, “peer-reviewed neurofibromatosis research,” and “peer-reviewed military
burn research” (See Appendix C).12
Specific details on the medical research topics and funding amounts appropriated for CDMRP are
not included in the text of the annual defense appropriations bill. Rather, they are incorporated in
accompanying congressional documents (i.e., conference reports or explanatory statements).
Congress typically allows DOD no more than two fiscal years to obligate CDMRP funds, in
keeping with the two-year obligation period generally authorized for other DOD R&D funding.13
Congressional Request Processes
Each year, the House Appropriations Committee (HAC) and Senate Appropriations Committee
(SAC) typically issue guidance to Members that outline the procedures for submitting requests

1993,” Senate debate, Congressional Record, vol. 138, part 17 (September 16, 1992), p. S25264.
10 Ibid. The Budget Enforcement Act of 1990 (P.L. 101-508) established certain caps (also referred to as “firewalls”)
on “defense, international, and non-defense discretionary spending.” These caps also restricted discretionary defense
spending from being “further reduced in order to increase spending for non-defense programs if it would cause total
non-defense spending to exceed its cap level.” For more, see U.S. Congress, Senate Committee on the Budget, The
Congressional Budget Process: An Explanation, committee print, prepared by Senate Committee on the Budget, 105th
Cong., 2nd sess., December 1998, S.Prt. 105-67 (Washington: GPO, 1998), pp. 17-18.
11 U.S. Congress, House Committee on Appropriations, Department of Defense Appropriations Act, 1993, Conference
report accompanying H.R. 5504, 102nd Cong., 2nd sess., October 5, 1992, H.Rept. 102-1015 (Washington: GPO, 1992),
p. 10 and p. 119.
12 U.S. Congress, House Committee on Appropriations, Committee Print of the Committee on Appropriations, U.S.
House of Representatives on H.R. 1158/P.L. 116-93, committee print, prepared by Legislative Text and Explanatory
Statement, 116th Cong., 1st sess., January 2020, H.Prt. 38-678 (Washington: GPO, 2020), p. 298,
https://www.govinfo.gov/content/pkg/CPRT-116HPRT38678/pdf/CPRT-116HPRT38678.pdf.
13 10 U.S.C. §3131. DOD defines an obligation as a “legally binding agreement or action that will result in outlays,
immediately or in the future.” For example, when a DOD authorized employee places an order, signs a contract, awards
a grant, purchases a service, or takes other “actions that require the Government to make payments to the public or
from one Government account to the other,” DOD incurs an obligation. For more on obligations, see DOD 7000.14-R,
Federal Management Regulation, Vol 3, Ch 8, Section 0803, February 2020, p. 8-11.
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for consideration in the appropriations process.14 Only Members of Congress may submit such
requests for specific medical research topics and funding amounts to be included in CDMRP
appropriations. A request is typically of interest to a Member or his/her constituency; requests
may also be submitted on behalf of an advocacy organization. In general, the House and Senate
use similar processes to solicit, receive, and consider Members’ funding requests for CDMRP.
Currently, each Chamber administers an electronic submission system to collect Member requests
and accompanying documentation (e.g., justification or support letters). Committee guidance
generally directs Members to rank the priority of their funding requests. Though guidance can
periodically change, a general overview of each appropriations committee’s request process is
described below.
House Appropriations Process for CDMRP Funding Requests
The HAC requires the submission of Member requests via an electronic submission system.15 The
committee requires Members to prioritize and assign rankings to funding requests, by HAC
subcommittee. For example, multiple funding requests for most defense-related programs are to
be prioritized and ranked against each other since they would be under the jurisdiction of the
HAC’s Subcommittee on Defense. Additionally, Members may prioritize and assign rankings to
their overall funding requests without regard to the specific appropriations bill or appropriations
subcommittee of jurisdiction.
When considering Member requests for CDMRP funding, professional staff members of the
HAC’s Subcommittee on Defense generally use the following criteria when reviewing submitted
documentation:
 military relevance;
 past precedent and history of CDMRP funding;
 number of Member requests for a specific medical research topic;
 a Member’s ranking of his/her overall funding requests (including requests for
CDMRP);
 potential outcomes from investing in a specific medical research topic; and
 DOD practicability to execute research funding.16
Senate Appropriations Process for CDMRP Funding Requests
The SAC requires the submission of Member requests via an electronic submission system, called
Legi-Mate.17 When considering Member requests for CDMRP funding, professional staff
members of the SAC’s Subcommittee on Defense generally use the following criteria when
reviewing submitted documentation:
 military relevance;
 past precedent and history of CDMRP funding;

14 For a general overview of the congressional appropriations process, see CRS Report R42388, The Congressional
Appropriations Process: An Introduction, coordinated by James V. Saturno.
15 The electronic submission system is available on the House intranet at https://AppropriationsSubmissions.house.gov.
16 Based on CRS discussions with HAC-D professional staff members, February 7, 2020.
17 The electronic submission system is available on the Senate intranet at https://appro-requests.senate.ussenate.us.
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 a Member’s ranking of his/her overall funding requests (including requests for
CDMRP);
 potential risks or outcomes from investing in a specific medical research topic;
and
 DOD practicability to execute research funding.18
Considering Member Requests
Professional staff members of the HAC and SAC review Member requests and consider the
inclusion of funding based on each committee’s established criteria, discretionary spending
parameters outlined in the budget resolution, and congressional prerogative.19 Though not
required, some Members opt to submit additional justification or letters of support to the
respective appropriations committee or the conference committee for their consideration of a
specific CDMRP funding request. When considering CDMRP funding requests, the HAC, SAC,
or conference committee may opt to add, remove, or consolidate research topics, or adjust the
assigned funding amounts.
Once the committee recommends and approves its version of the defense appropriations bill,
proposed CDMRP funding lines and eligible research topics are typically assigned in the DHP
RDT&E budget activity, with further details on eligible research topics included in the
accompanying committee report. If permitted by Chamber rules, the House or Senate may amend
the CDMRP funding amounts and eligible research topics during the floor consideration
process.20
Congressional Ban on Earmarks
CDMRP funding is described as congressionally directed spending; however, it appears not to be
currently considered an earmark by Congress. Since the 112th Congress, the House and Senate
began observing a so-called earmark ban. The ban does not exist in House or Senate chamber
rules, but has been established by party rules and committee protocols and is enforced by
chamber and committee leadership through their agenda-setting power.21
While the earmark ban is not in House and Senate rules, the chamber rules do include a definition
of earmarks as congressionally directed spending, tax benefits, or tariff benefits intended for a
“specific entity or state, locality, or congressional district.”22 The definitions also suggest that
when executed through a “statutory or administrative formula driven or competitive award
process,” provisions would not be considered to be earmarks.23 Presumably, since MRDC uses a
competitive award process (i.e., grants) to execute CDMRP funds, such appropriations are not
technically considered earmarks under current House and Senate practices.

18 Based on CRS discussions with SAC-D professional staff members, February 14, 2020.
19 Based on CRS discussions with HAC-D professional staff members on February 7, 2020; SAC-D professional staff
members, February 14, 2020; and CRS In Focus IF10514, Defense Primer: Defense Appropriations Process, by James
V. Saturno and Brendan W. McGarry.
20 For more on the House or Senate floor consideration process, see pp. 6-7 of CRS Report R42843, Introduction to the
Legislative Process in the U.S. Congress, by Valerie Heitshusen.
21 For a summary of each Chamber’s definition of earmark, see ibid., p. 1.
22 CRS Report R45429, Lifting the Earmark Moratorium: Frequently Asked Questions, by Megan S. Lynch.
23 House Rules XXI, clause 9 and Senate Rules XLIV, paragraph 5.
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Administration of CDMRP Funding
DOD Program Administration
Ultimately, the Secretary of Defense is accountable for executing congressional appropriations for
CDMRP. The U.S. Army Medical Research and Development Command (MRDC) is the DOD-
designated executive agent for CDMRP and other medical research activities funded by the DHP
and Department of the Army RDT&E budget activities.24 MRDC and DHA exercise primary
responsibility for CDMRP oversight, program execution, grant management, follow-on research,
and implementation science activities (see Figure 1).
Figure 1. DOD Governance of CDMRP

Source: CRS graphic based on DOD, Department of Defense Strategic Medical Research Plan, pp. 29-30; and
CDMRP, About Us, “Our Team,” accessed September 28, 2020, https://cdmrp.army.mil/about/ourteam.
CDMRP Grants
MRDC uses a competitive grant process to award CDMRP funds. When Congress appropriates
funds for a new CDMRP research topic, MRDC convenes a meeting of stakeholders (e.g., DOD
and non-DOD clinicians, scientists, consumers, industry representatives, academicians, and other

24 DOD, Department of Defense Strategic Medical Research Plan, January 29, 2019, pp. 29-30. The U.S. Army
Medical Research and Development Command is formerly the U.S. Army Medical Research and Materiel Command.
The name change took place in 2019. For more, see C.J. Lovelace, “Army Logistics Leaders Focus on Medical
Materiel’s Role in Readiness,” Army Medical Logistics Command, September 10, 2019, https://amlc.army.afpims.mil/
News/Article/1956385/army-logistics-leaders-focus-on-medical-materiels-role-in-readiness.
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interested parties) to discuss the current research landscape and identify certain research gaps and
opportunities. Stakeholder-developed recommendations influence the vision setting process,
which determines the program’s specific research goals, investment strategy, and award
mechanisms and amounts. A programmatic panel of civilian and military medical and scientific
experts, as well as consumers, conducts the vision setting process. Established CDMRP programs
periodically repeat these processes to revise their research goals based on new or existing gaps
and opportunities and to integrate congressional direction, if any.25
Based on the goals and programmatic details established during the vision setting process, MRDC
issues periodic program announcements or broad agency announcements to alert researchers of
CDMRP grant opportunities.26 The announcements typically include detailed descriptions of
funding mechanisms, evaluation criteria, anticipated award amounts, submission requirements,
and deadlines. MRDC publishes grant announcements on the Grants.gov website or the CDMRP
website.27 Grants are made available to intramural (within DOD) and/or extramural (non-DOD)
researchers. Depending on the details included in each grant announcement, the Grants.gov
website or the electronic biomedical research application portal (eBRAP) are the designated
application submission portals.28
Reviewing and Selecting CDMRP Grant Applications
MRDC uses a two-tiered review process when considering CDMRP grant applications.
 Peer Review. This review evaluates a proposal based on certain grant
announcement evaluation criteria and determines whether a proposal is of
“absolute” scientific merit.29 Peer reviewers typically include at least two
scientific experts that focus on a specific health condition or aspect thereof, and
at least one consumer reviewer.30
 Programmatic Review. This review evaluates a proposal based on certain grant
application evaluation criteria, relevance to the DHP and the specific research
program’s goals, in comparison with other proposals.31
At the conclusion of these two reviews, the CDMRP Director validates the eligibility and funding
amounts available for each recommended application.32 Once the DHA R&D Director and the
MRDC Commanding General conduct a final review of the recommended applications and issue
a concurrence, MRDC then notifies individual researchers of their selection status and publishes a
list of selected applications on the CDMRP website.

25 CDMRP, “2019 Annual Report: Congressionally Directed Medical Research Programs,” September 30, 2019, p. 7,
https://cdmrp.army.mil/pubs/annreports/2019annrep/2019annreport.pdf.
26 A Broad Agency Announcement (BAA) is a method that allows federal departments and agencies to solicit for the
“acquisition of basic and applied research…not related to the development of a specific system or hardware
procurement.” For more on BAAs, see Federal Acquisition Regulation (FAR) §35.016.
27 The CDMRP website is available at http://cdmrp.army.mil/.
28 For more on eBRAP, see http://ebrap.org/.
29 CDMRP, About Us, “CDMRP’s Two-Tiered Review Process,” accessed September 28, 2020,
https://cdmrp.army.mil/about/2tierRevProcess.
30 Individuals affiliated with other federal departments or agencies, academia, industry, or advocacy organizations may
participate in the peer review process.
31 National Academies of Science, Engineering, and Medicine, “Programmatic Review,” in Evaluation of the
Congressionally Directed Medical Research Programs, pp. 92-93, https://www.nap.edu/catalog/23652/evaluation-of-
the-congressionally-directed-medical-research-programs-review-process.
32 Ibid., pp. 95-96.
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CDMRP Award Management
MRDC typically disburses CDMRP awards in increments. Awardees receive these increments
when meeting certain programmatic or administrative milestones negotiated prior to the initial
distribution of funds. Throughout the duration of the award management period, which can span
several years, MRDC requires researchers to provide periodic financial statements and progress
reports. At the conclusion of the award management period, researchers are to submit a final
report on their overall findings, financial accounting, and transition plans for follow-on research,
if applicable. MRDC flags additional follow-up items, such as significant discoveries, patents,
invention disclosures, publications, or need for additional funding support.
Figure 2 summarizes the overall CDMRP grant process, from when Congress appropriates funds
to grant closeout and research publication.
Figure 2. CDMRP Grant Process

Source: CDMRP, About Us, “Funding Process,” accessed September 28, 2020, https://cdmrp.army.mil/about/
funding process.
Historical Funding Trends
Congress’s initial appropriation for CDMRP was $25 million in FY1992. With the addition of
other medical research topics and funding amounts over time, annual appropriations have grown
drastically. In FY2022, CDMRP received $1.55 billion in congressional appropriations.33 Figure
3 shows historical CDMRP appropriation amounts.

33 DOD, “About Us,” Funding History, accessed June 15, 2022, https://cdmrp.army.mil/about/fundinghistory; and DHP
and Department of the Army RDT&E accounts included in the explanatory statement accompanying the Department of
Defense Appropriations Act, FY2022. Between FY1992 and FY2022, congressional appropriations for CDMRP grew
18.5 times its initial appropriation amount (adjusted for inflation to FY2022 dollars using DOD’s deflators for the
Defense Health Program and excluding pay and fuel).
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Figure 3. Congressional Appropriations for CDMRP, FY1992-FY2022
(in nominal dollars)

Source: CRS analysis of DOD, “About Us,” Funding History, accessed June 15, 2022, https://cdmrp.army.mil/
about/fundinghistory; and explanatory statements accompanying the Department of Defense Appropriations Act,
FY1992-FY2022.
Note: Nominal dol ars, not adjusted for inflation.
CDMRP Research Programs
CDMRP funding has supported more than 50 unique research programs or topics (see Appendix
E). The largest programs (by cumulative funding amounts between FY1992 and FY2022) are the:
 Breast Cancer Research Program ($4.09 billion);
 Peer-Reviewed Medical Research Program (PRMRP; $3.45 billion);
 Prostate Cancer Research Program ($2.15 billion);
 Psychological Health/Traumatic Brain Injury Research Program ($1.61 billion);
and
 Peer-Reviewed Cancer Research Program (PRCRP; $784.80 million).34
Peer-Reviewed Medical Research Program (PRMRP)
Since FY1999, Congress has included a funding line for PRMRP, which appropriates funds for
medical research activities on any of the eligible topics identified by Congress. MRDC may
competitively award grants for any of the eligible topics designated for a fiscal year. Between
FY1999 and FY2018, the PRMRP has awarded 1,385 grants, resulting in 2,700 peer-reviewed

34 CRS analysis of DOD, “About Us,” Funding History, accessed June 15, 2022, https://cdmrp.army.mil/about/
fundinghistory; and explanatory statements accompanying the Department of Defense Appropriations Act, FY1992-
FY2022.
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publications and 243 patent applications or issuances.35 Appendix F lists the historical PRMRP
eligible research topics.
Peer-Reviewed Cancer Research Program (PRCRP)
Since FY2009, Congress has included a funding line for PRCRP, which appropriates funds for
medical research activities on any of the eligible cancer-related topics identified by Congress.
MRDC may competitively award grants for any of the eligible topics designated for a fiscal year.
Between FY2009 and FY2017, the PRCRP has awarded approximately 502 grants resulting in at
least 143 peer-reviewed publications.36 Appendix G lists the historical PRCRP eligible cancer-
related research topics.
Issues for Congress
DHP RDT&E Cost Growth
In recent years, CDMRP funding has accounted for at least half of the DHP RDT&E budget
activity (see Figure 4). On average, between FY2003 and FY2022, the base budget (non-
CDMRP) for DHP RDT&E increased by 7% per year. Concurrently, CDMRP funding also
increased by an average of 6% per year. Since FY2015, annual congressional appropriations for
CDMRP have exceeded $1 billion.

35 CDMRP, “Peer Reviewed Medical Research Program Strategic Plan,” 2019, p. 2, https://cdmrp.army.mil/prmrp/
pbks/PRMRP%20Strategic%20Plan.pdf.
36 CDMRP, “Peer Reviewed Cancer Research Program Strategic Plan,” 2018, p. 2 and p. 8, https://cdmrp.army.mil/
prcrp/pdf/PRCRP%20Strategic%20Plan.pdf.
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Figure 4. DHP RDT&E and CDMRP Funding Proportions and Amounts
FY2003-FY2022

Source: CRS analysis of DOD, Defense Health Program Fiscal Year Budget Estimates, Volume 1, Section 2,
FY2004-FY2023, https://comptrol er.defense.gov/Budget-Materials/FY2023BudgetJustification/#defhealthprog; and
DOD, “About Us,” Funding History, accessed June 15, 2022, https://cdmrp.army.mil/about/fundinghistory.
In most years since FY2003, CDMRP funding exceeded DOD’s actual request for medical
research funding.37 Some Members of Congress have noted that this trend with CDMRP funding
may be potentially unnecessary growth in the DHP RDT&E budget activity and poses certain
risks to other defense programs subject to certain statutory budget caps on discretionary
spending.38 For example, the conference report accompanying the FY2018 NDAA (P.L. 115-91)
references these concerns and suggests that DOD medical research focus only on military-
relevant topics:
Annual funding for CDMRP has more than doubled since 2013, when budget caps
mandated by the Budget Control Act of 2011 (P.L. 112-25) took effect. This funding,
neither authorized by Congress nor requested by DOD, is increasing at a time when other
vital programs critical to the nation’s defense are dangerously underfunded. As long as the
budget caps remain in place under the Budget Control Act, additional funds placed in the
CDRMP will directly compete with other budget priorities in the Department. While the
conferees agree that DOD has a proper and vital role to play in medical research related to
combat readiness, especially in areas like prosthetics, traumatic brain injury, and spinal
cord injury, additional funding for medical research unrelated to unique military needs
should be allocated elsewhere in the federal government. Therefore, the conferees
encourage funding only those medical research and development projects that protect and

37 CRS analysis of DOD, Defense Health Program Fiscal Year Budget Estimates, Volume 1, Section 2, FY2004-
FY2023, https://comptroller.defense.gov/Budget-Materials/FY2021BudgetJustification/#defhealthprog; and DOD,
“About Us,” Funding History, accessed June 15, 2022, https://cdmrp.army.mil/about/fundinghistory.
38 For more on the defense-related discretionary spending caps, see CRS Report R44039, The Defense Budget and the
Budget Control Act: Frequently Asked Questions, by Brendan W. McGarry.
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enhance military readiness or restore the health and safety of members of the Armed
Forces.39
Observers also note that some CDMRP funds, particularly topics with limited or seemingly no
military relevance, should be excluded from the DOD budget or reinvested toward a research area
more applicable to military needs.40 In doing so, DOD could curb its growing medical costs and
eliminate nonmilitary-related activities from the defense budget. Alternatively, increases to the
DHP RDT&E budget activity (including CDMRP) could serve as an option to continue medical
research activities in lieu of potentially declining or fluctuating funding at other federal
agencies.41 Congress could consider potential options to constrain or further optimize funding and
outcomes of DOD’s medical research programs.
Military Relevance
While funding for CDMRP has generally increased each year since the program’s inception,
numerous stakeholders and observers have noted that certain CDMRP research topics do not
directly relate to DOD’s statutory mission, military operations, or national security. In 2016,
Congress considered a restriction on DOD’s use of CDMRP funds unless the Secretary of
Defense determined that such research project would “enhance, or restore the health and safety of
members of the Armed Forces.”42 The proposed restriction was included as Section 756 of the
Senate-passed version of the NDAA for Fiscal Year 2017. While the provision was not included
in the enacted NDAA (P.L. 114-328), the conferees noted their concern on:
… the amount of congressional funding for medical research in the Department of
Defense’s (DOD) Congressionally Directed Medical Research Program. Since 1992,
Congress has appropriated almost $10 billion for medical research—most of it outside of
the DOD’s core medical research mission and not requested in the Department’s annual
budget requests.43
In contrast, other observers have welcomed the use of CDMRP funds for a broad range of
research topics that support both DOD’s mission and the general medical community. During a
2013 congressional hearing on the Defense Health Program budget, then-Assistant Secretary of
Defense for Health Affairs (ASD[HA]) Jonathan Woodson thanked Congress for “supporting
Congressionally-directed research programs” and also noted that such funds added “value to
military medicine but obviously American medicine by the advances that are made.”44 Certain
advocacy organizations (e.g., the National Breast Cancer Coalition) also note that outcomes from
some CDMRP research topics also affect service members, veterans, and military families, in
addition to the general public, because they are also at risk for those medical conditions.45

39 See pp. 861-862 of H.Rept. 115-404.
40 See Heritage Foundation, “The Budget Book: 106 Ways to Reduce the Size & Scope of Government,” 050 National
Defense: Cut Funding for Non-Combat Related Research,” accessed October 5, 2020, https://budgetbook.heritage.org/
national-defense/cut-funding-for-non-combat-related-research/.
41 See Research America, “U.S. Investment in Medical and Health Research and Development: 2013-2018,” Fall 2019,
https://www.researchamerica.org/sites/default/files/Publications/InvestmentReport2019_Fnl.pdf.
42 Senate-passed National Defense Authorization Act for Fiscal Year 2017, S. 2943, 114th Congress, 2nd Session.
43 H.Rept. 114-840, p. 1089.
44 U.S. Congress, House Committee on Appropriations, Subcommittee on Defense, Department of Defense
Appropriations for 2013, 112th Cong., 2nd sess., March 8, 2012, H. Hrg. 79-874 (Washington: GPO, 2013), p. 255,
https://www.govinfo.gov/content/pkg/CHRG-112hhrg79874/pdf/CHRG-112hhrg79874.pdf.
45 For example, see Testimony of the National Breast Cancer Coalition President Fran Visco, in U.S. Congress, House
Committee on Appropriations, Subcommittee on Defense, April 8, 2020, https://www.stopbreastcancer.org/resources/
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The Constitution authorizes Congress to make appropriations regardless of whether those funds
are relevant to a federal agency’s mission or responsibilities.46 Utilizing the constitutional “power
of the purse,” Congress could continue to consider the ad-hoc or permanent practice of including
CDMRP funding in the annual DOD appropriations act, as well as consider restrictions on the use
of medical research funding for perceived nonmilitary related purposes.
Research Continuity
CDMRP research areas are contingent on annual congressional appropriations and are not static.
For example, Congress provided annual funding for tick-borne disease research from FY2016 to
FY2020, but provided no associated funds in FY2015. Unclear funding certainty can challenge
DOD medical research leaders during the vision-setting process. Without a clear timeline on
congressional appropriations for a specific topic, it is difficult to establish an investment strategy
and to prioritize short-term and long-term research goals. Though awarded CDMRP grants help to
define and contribute scientific insight on individual research questions relating to a funded topic,
it can sometimes be unclear if the grant helped to meet DOD’s overarching goals or if any
research findings directly contributed to the development of new technology, biologics,
pharmaceuticals, therapies, or clinical treatments for the military’s needs.
For example, Congress appropriated a total of $4.4 million in FY2009 and FY2010 for a “Genetic
Studies of Food Allergies Research Program” (GSFARP).47 MRDC awarded nine grants to
explore a “highly innovative new concept or untested theory” and “innovative ideas and high-
impact research approaches” using scientifically meritorious genetic research focused on food
allergies.48 At the conclusion of the grant periods, GSFARP awardees produced 17 articles in
peer-reviewed medical journals discussing their findings.49 However, DOD has not clearly
described whether, or how, those findings contributed to military medicine, or if continued
research would have likely been valuable for DOD’s purposes or the broader healthcare
community.
Since FY1992, there have been 19 CDMRP research topics funded for four years or less.50 It is
possible that DOD could have found additional value from continued research if such topics were
funded for a longer period. Congress may have stopped funding of those topics after realizing
other federal entities could more appropriately conduct that research. Congress could consider
incorporating certain CDMRP research topics into DOD’s RDT&E base budget, exploring multi-
year appropriations, or utilize congressional authorizations to establish and sustain a long-term

testimony-of-fran-visco-before-the-house-appropriations-subcommittee-on-defense-april-8-2020/; National Multiple
Sclerosis Society, Congressional Talking Points, “MS Congressionally Directed Medical Research Program (CDMRP)
Funding,” August 2016, http://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Advocacy/
NEW-MS-CDMRP-Talking-Points,-August-Recess-201671816_1.pdf; and Lupus Foundation of America,
“Department of Defense: Lupus Research Program,” accessed October 4, 2020, https://www.lupus.org/lupus-research-
program.
46 Article I, Section 9, Clause 7, U.S. Constitution.
47 Explanatory statements accompanying the Department of Defense Appropriations Act, 2009 (P.L. 110-329), and
Department of Defense, 2010 (P.L. 111-118).
48 CDMRP, “Genetic Studies of Food Allergies Research Program,” October 2010, https://cdmrp.army.mil/prevfunded/
gsfarp/pbks/gsfarppbk.pdf.
49 CRS analysis of CDMRP grant awards and publications for the GSFARP, available at https://cdmrp.army.mil/
search.aspx.
50 CRS analysis of historical CDMRP funding, available at DOD, “About Us,” Funding History, accessed June 15,
2022, https://cdmrp.army.mil/about/fundinghistory.
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medical research agenda across federal agencies to mitigate the funding challenges and
uncertainties affecting research continuity.
Duplication and Overlap with other Federal Research Entities
Aside from DOD’s medical research enterprise, other federally administered and/or funded
entities also conduct medical research that may overlap certain CDMRP research topics. These
include
 NIH;
 U.S. Centers for Disease Control and Prevention;
 Agency for Toxic Substances and Disease Registry;
 Biomedical Advanced Research and Development Agency;
 Food and Drug Administration;
 Veterans Health Administration of the Department of Veterans Affairs (VA);
 National Science Foundation; and
 Department of Agriculture.
MRDC prohibits “unnecessary duplication of funding, or accepting funding from more than one
source for the same research.”51 During the CDMRP application, review, and award management
process, research duplication is assessed. MRDC terminates CDMRP grants identified as
unnecessarily duplicative and awardees are required to refund the government for any previously
disbursed funds. DOD’s process to monitor and identify unnecessary duplication is the
responsibility of “research applicants and their institutional business officials.”52 Because the
onus is primarily on the researcher, such overlap may go unreported or be misidentified.
Recent evaluations of CDMRP also identified opportunities to reduce the likelihood of research
duplication and overlap with other federal entities. In 2012, the Government Accountability
Office (GAO) found that “NIH, DOD, and VA each lack comprehensive information on health
research funded by the other agencies, which limits their ability to identify potential areas of
duplication in the health research they fund.”53 GAO recommended that the three federal
departments “determine ways to improve access to comprehensive electronic information on
funded health research shared among agency officials and improve the ability of agency officials
to identify possible duplication.”54 DOD concurred with GAO’s findings, while NIH noted they
do coordinate and have access to other agencies’ publicly available research databases to check
for duplicative research efforts and projects.55 Currently, CDMRP and certain other DOD medical
research programs share its grant award data with the Federal RePORTER database to promote

51 CDMRP, “Funding Opportunities,” Research Duplication, accessed October 4, 2020, https://cdmrp.army.mil/
funding/researchDup.
52 DOD, Department of Defense Strategic Medical Research Plan, January 29, 2019, p, 50.
53 U.S. Government Accountability Office, 2012 Annual Report: Opportunities to Reduce Duplication, Overlap and
Fragmentation, Achieve Savings, and Enhance Revenue, GAO-12-342SP, February 2012, p. 97, https://www.gao.gov/
assets/590/588818.pdf.
54 Ibid., p. 100.
55 Ibid., p. 100 and p. 393.
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“transparency” of “federal science research investments;” however, it is unclear how the database
is utilized to reduce duplication or overlap among federal agencies.56
In 2016, the National Academies of Science, Engineering, and Medicine evaluated the CDMRP
review processes and recommended CDMRP have a “formal mechanism to coordinate with these
entities in a predictable, consistent, and standardized manner each year to learn of substantial or
new areas of research on the health condition being funded or considered for funding by those
other organizations.”57 Though DOD invites representatives from other federal entities (e.g., VA,
NIH) to participate in certain grant development and review processes, the processes are not
standardized. For example, programmatic panels for certain research topics do not include a VA
representative, even if the topic may affect the veteran population.
GAO reviewed CDMRP again in 2021 and found that “DOD officials coordinate with NIH and
VA counterparts on CDMRP-funded research programs throughout their cyclical program and
project management process.”58 The organization also found that DOD’s coordination activities,
like querying an interagency database of research projects, helps CDMRP avoid and mitigate
“overlap and duplication of biomedical research efforts across DOD, NIH, and VA.”59
Comprehensive interagency coordination occurs on certain topics to establish unique research
priorities without duplication or overlap, while other topics are coordinated on an ad hoc basis, or
not at all. Congress may consider enhancing the interagency coordination process by exploring
opportunities to designate a lead federal agency or further define an agency’s scope and
responsibility for conducting research activities on certain topics.
Military Health System Reform
The MHS is undergoing numerous congressionally directed reforms intended to reorganize the
internal structure of the DHA and how military treatment facilities are managed and
administered.60 In 2019, Congress directed DOD to consolidate most of its medical research and
public health programs under the DHA, with a deadline of September 30, 2022.61 While the
military departments are to retain certain medical research and public health responsibilities, the
DHA is to be responsible for coordinating all DHP RDT&E and public health funds, including
CDMRP.62
In June 2019, MRDC restructured and realigned certain responsibilities under two separate DOD
entities: the DHA and Army Futures Command.63 Depending on the research mission (DHP

56 The Federal RePORTER database is an interagency data repository of federal research and development investments.
The database is administered by NIH and the National Science Foundation and includes federal partners, such as:
DOD, Department of Agriculture, Environmental Protection Agency, VA, Department of Education, and the National
Aeronautics and Space Administration. For more, see https://federalreporter.nih.gov/.
57 National Academies of Science, Engineering, and Medicine, “Programmatic Review,” in Evaluation of the
Congressionally Directed Medical Research Programs, p. 122.
58 U.S. Government Accountability Office, Biomedical Research: Observations on DOD’s Management of
Congressionally Directed Medical Research Programs, GAO-22-105107, January 31, 2022, p. 7,
https://www.gao.gov/assets/gao-22-105107.pdf.
59 Ibid.
60 For more on MHS reform, see CRS In Focus IF11273, Military Health System Reform, by Bryce H. P. Mendez.
61 P.L. 115-232 §711.
62 For more on the Congressionally Directed Medical Research Programs (CDMRP), see CRS In Focus IF10349,
Congressionally Directed Medical Research Programs Funding for FY2022, by Bryce H. P. Mendez.
63 The U.S. Army Medical Research and Development Command was previously the U.S. Army Medical Research and
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requirements vs. service-specific requirements), MRDC resources were also reallocated
accordingly.64 MRDC, a Department of the Army entity, executes most of the annual DHP
RDT&E funds. However, the FY2019 NDAA requires DHA’s R&D directorate to be “comprised
of the Army Medical Research Materiel Command [now known as MRDC] and such other
medical research organizations and activities of the armed forces as the Secretary considers
appropriate.”65 The FY2020 NDAA (P.L. 116-92) also stipulated that MRDC is to retain certain
resources for its service-based research mission and is to transfer its DHP RDT&E accounts to the
DHA on October 1, 2022.66
In December 2019, the Secretary of the Army relayed certain concerns with transferring MRDC
to the DHA in a memorandum to the Deputy Secretary of Defense, noting that DHA and the
Office of the Assistant Secretary of Defense for Health Affairs have “failed to provide a clear path
forward with respect to policy and budget.”67 The Secretary of the Army also requested support
for “Army’s legislative proposal to repeal the portion of the NDAA FY19 legislation, which
transfers Army Public Health and Medical Research and Material to DHA.”68
Given the military services’ lingering concerns with required MHS reform efforts, Congress may
consider enacting further legislation or conduct oversight activities to clarify or emphasize its
intent regarding DHA’s and the services’ roles and responsibilities with regard to CDMRP
funding.
Congressional Outlook
With more than $18 billion in funding since FY1992, CDMRP has been a significant contributor
to both DOD’s R&D mission, as well as the overall U.S. medical research enterprise. As future
appropriations and authorizations for DOD’s medical RDT&E programs are considered,
Congress may opt to reflect on overall federal medical research investments and the departments
and agencies administering those funds. In doing so, Congress could potentially enhance how
federal medical research is administered, realign medical research efforts with capable federal
entities, and/or maximize the benefits of federal medical research investments to taxpayers.

Materiel Command. C.J. Lovelace, “Army Logistics Leaders Focus on Medical Materiel’s Role in Readiness,” Army
Medical Logistics Command, September 10, 2019, https://amlc.army.afpims.mil/News/Article/1956385/army-logistics-
leaders-focus-on-medical-materiels-role-in-readiness/. For more on the Army Futures Command, see CRS Insight
IN10889, Army Futures Command (AFC), by Andrew Feickert.
64 Ibid.
65 P.L. 115-232 §711(b).
66 P.L. 116-92 §737.
67 A copy of the memorandum was obtained and published in Scott Maucione, “Internal memo shows Army wants to
halt MTF transfers to DHA,” Federal News Network, January 17, 2020, https://federalnewsnetwork.com/army/2020/01/
exclusive-internal-memo-shows-army-wants-to-halt-mtf-transfers-to-dha/.
68 Ibid. DOD’s legislative proposals for FY2021 did not include any draft legislative text that would repeal Section 711
of the FY2019 NDAA.
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Appendix A. Acronyms
Glossary of Acronyms
ASD(HA)
Assistant Secretary of Defense for Health Affairs
BAA
Broad Agency Agreement
CDMRP
Congressionally Directed Medical Research Programs
DHA
Defense Health Agency
DHP
Defense Health Program
DOD
Department of Defense
eBRAP
Electronic Biomedical Research Application Portal
FY
Fiscal Year
GAO
Government Accountability Office
GSFARP
Genetic Studies of Food Allergies Research Program
HAC
House Appropriations Committee
HAC-D
House Appropriations Committee – Subcommittee on Defense
MHS
Military Health System
NASEM
National Academies of Science, Engineering, and Medicine
NDAA
National Defense Authorization Act
NIH
National Institutes of Health
PRCRP
Peer-Reviewed Cancer Research Program
PRMRP
Peer-Reviewed Medical Research Program
R&D
Research and Development
RDT&E
Research, Development, Test, and Evaluation
SAC
Senate Appropriations Committee
SAC-D
Senate Appropriations Committee – Subcommittee on Defense
MRDC
United States Army Medical Research and Development Command
VA
Department of Veterans Affairs

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Appendix B. CDMRP Funding – DHP RDT&E
Budget Activity
Figure B-1. CDMRP Funding Assigned to the DHP RDT&E Budget Activity
Department of Defense Appropriations Act, 2020

Source: Explanatory statement accompanying the Department of Defense Appropriations Act, 2020, as
incorporated in the Consolidated Appropriations Act, 2020, H. Comm. Prt. 38-678, p. 372,
https://www.govinfo.gov/content/pkg/CPRT-116HPRT38678/pdf/CPRT-116HPRT38678.pdf.
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Appendix C. CDMRP Funding – Army RDT&E
Budget Activity
Figure C-1. CDMRP Funding Assigned to the Army RDT&E Budget Activity
Department of Defense Appropriations Act, 2020

Source: Explanatory statement accompanying the Department of Defense Appropriations Act, 2020, as
incorporated in the Consolidated Appropriations Act, 2020, H. Comm. Prt. 38-678, p. 298,
https://www.govinfo.gov/content/pkg/CPRT-116HPRT38678/pdf/CPRT-116HPRT38678.pdf.
Note: RDT&E = Research, Development, Testing, and Evaluation.
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Appendix D. Example of a Call for Member
Funding Requests, House of Representatives
Figure D-1. Example of a Call for Member Funding Requests
House of Representatives

Source: e-Dear Col eague email from U.S. House of Representatives, Committee on Appropriations,
Subcommittee on Defense, “Member Submissions for FY 2021 Defense Appropriations,” sent on February 7,
2020.
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Appendix E. CDMRP Programs and Cumulative Funding, FY1992-FY2022
Figure E-1. CDMRP Programs and Cumulative Funding
FY1992-FY2022
Cumulative
Cumulative
Research Topics
Research Topics
Total (millions)
Total (millions)
Alcohol and Substance Abuse Disorders
$ 32

Multiple Sclerosis
$ 113

Amyotrophic Lateral Sclerosis
$ 189

Myeloproliferative Disorders
$ 4

Autism
$ 134

National Prion
$ 43

Bone Marrow Failure
$ 57

Neurofibromatosis***
$ 403

Breast Cancer
$ 4
,086 Neurotoxin Exposure Treatment Parkinson's***
$ 144

Breast Cancer Research Semipostal
$ 27

Orthotics and Prosthetics Outcomes
$ 110

Chronic Myelogenous Leukemia
$ 22

Osteoporosis
$ 5

Chronic Pain Management
$ 25

Ovarian Cancer
$ 451

Combat Readiness-Medical
$ 25

Pancreatic Cancer
$ 6

Defense Women's Health
$ 40

Peer Reviewed Alzheimer's
$ 129

Deployment Related Medical
$ 102

Peer Reviewed Cancer
$ 785

DOD/VA Medical
$ 7

Peer Reviewed Medical
$ 3
,451
Duchenne Muscular Dystrophy
$ 60

Peer Reviewed Orthopaedic
$ 489

Epilepsy
$ 74

Prostate Cancer
$ 2
,150
Genetic Studies of Food Allergies
$ 4

Rare Cancers
$ 8

Gulf War Illness
$ 236

Reconstructive Transplant
$ 99

Hearing Restoration
$ 60

Scleroderma
$ 5

Institutionally Based Programs
$ 486

Spinal Cord Injury
$ 398

Joint Warfighter Medical
$ 474

Tick-Borne Disease
$ 41

Kidney Cancer
$ 185

Toxic Exposures
$ 30

Lung Cancer
$ 196

Trauma Clinical Research Repository
$ 5

Lupus
$ 45

Tuberous Sclerosis Complex
$ 105

Melanoma
$ 30

Vision
$ 149

Military Burn
$ 78

CDMRP-supported DOD Programs/Projects
Armed Forces Institute of Regenerative Medicine II
$ 31

Psychological Health/Traumatic Brain Injury
$ 1
,614
Armed Forces Institute of Regenerative Medicine III
$ 20

Rapid Innovation Fund
$ 36

Centers of Excellence
$ 20

Small Business Innovation Research/Small Business Technology Transfer $ 64

Defense Medical RDT&E
$ 943

Trauma Clinical
$ 70

Defense Medical RDT&E CSI Restoral
$ 180

Vision Prosthesis
$ 1

Medical Technology Enterprise Consortium
$ 26

Source: CRS analysis of DOD, “About Us,” Funding History, accessed June 15, 2022, https://cdmrp.army.mil/about/fundinghistory.
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Appendix F. PRMRP Eligible Research Topics,
FY1999-FY2022
Figure F-1. PRMRP Eligible Research Topics
FY1999-FY2022
Acellular Human Tissue Matrix
Dystonia
Acupuncture
Early Trauma Thermal Regulation
Acute Lung Injury
Eating Disorders
Advanced Prosthetics
Ehlers-Danlos Syndrome
Advanced Proteomics
Emerging Infectious Diseases
Advanced Soft Tissue Modeling
Emerging Viral Diseases
Alcoholism
Endometriosis
Amyotrophic Lateral Sclerosis
Epidermolysis Bullosa
Anti-Diarrhea Supplement
Epilepsy
Antimicrobial Resistance
Eye and Vision
Anti-radiation Drug Development
Familial Hypercholesterolemia
Army Nutrition
Fibromyalgia
Arthopod-transmitted Infectious Diseases
Fibrous Dysplasia
Arthritis
Friedreich's Ataxis
Augmented Care in the Chain of Survival (ACCESS)
Focal Segmental Glomerulosclerosis
Autism
Food Allergies
Autoimmune Diseases
Fragile X
Biological Hazard Detection System/Biosensor Microchip
Freeze-Dried Platelets
Blood Cancer
Frontotemporal Degeneration
Bone-related Disease
Fungal & Bacterial Infections
Burn Pit Exposure
Fungi Free - topical agent for Onychomycosis
Cardiomyopathy
Geneware Rapid Vaccines
Cardiovascular Health
Guillain-Barre Syndrome
Casualty care
Hanta Virus
Cell Response to Anti-cancer Agents
Health Information Protection
Cerebellar Ataxia
Health System Information Technology
Cervical Cancer - Self-Test/Screening Methods
Healthcare Informatics
Chemical Weapons
Healthcare-acquired Infection Reduction
Chemo-preventative Approaches to Smoking-related Illnesses
Hemorrhage Control
Childhood Asthma
Hepatitis B
Childhood Cancer
Hepatitis B and C
Chiropractic Care
Hereditary Angioedema
Chronic Kidney Disease
High Risk Infectious Disease
Chronic Migrane & Post-Traumatic Headache Human Imaging Institute/Magnetoencephalography Lab
Chronic Pain Management
Hydrocephalus
Closed Loop Frozen Blood Processing Systems
Hypercholesterolemia
Complex rAD-Vector Vaccine for MGBV
Hypertension
Composite Tissue Transplantation
Illnesses related to Radiation Exposure
Congenital Heart Disease
Immunomonitoring of Intestinal Transplants
Conjugate Vaccines for Shigellosis
Infectious Disease Tracking System
Constrictive Bronchiolitis
Infectious Disease Vaccines
Counter Narcotics Tactical Operations Medical Support Program (CONTOMS)
Inflammatory Bowel Disease
Defense & Veterans Head Injury Program
Influenza
Dengue
Integrated Tissue Hypoxia
Diabetes
Integrative Medicine
Diarrheal Diseases
Interstitial Cystitis
Digital Mammography
Interventional Cardiovascular MRI Technologies
Disease Management
Kidney Cancer
DNA Vaccine Technology for Postexposure Prophylaxis
Laser Eye Injury/Eye Cancer
Drug Abuse
Leshmaniasis
Duchenne's Disease
Limb Loss and Paralysis
Source: CRS analysis of DOD, “About Us,” Funding History, accessed June 15, 2022, https://cdmrp.army.mil/
about/fundinghistory; and explanatory statements accompanying various DOD Appropriations Acts, FY1999-
FY2022.
Note: Additional PRMRP eligible research topics continued on next page.
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Figure F-2. PRMRP Eligible Research Topics (Continued)
FY1999-FY2022
Listeria Vaccine for Infectious Disease & Cancer
Personal Intelligent Medical Assistant
Low Vision
Pheochromocytoma
Lung
Plant-based Vaccines
Lung Cancer - CAT Scan Technology
Platelet-Like Cell Production
Lung Injury
Polycystic Kidney Disease
Lupus
Post-traumatic Osteoarthritis
Lymphoma
Post-traumatic Stress Disorder/Gulf War Illness
Malaria Pre-clinical/Clinical activities of the Novonex/Ex-rad Drugs
Medical Digital Assistance
Pressure Ulcers
Medical Records Management
Providence Cancer Research
Medical Surgery Technology
Prsotate Diagnostic Imaging
Melanoma
Psychotropic Medications
Mesothelioma
Pulmonary Fibrosis
Metabolic Disease
Pulmonary Hypertension
Metabolically Engineered Tissue for Trauma Care
Quantum Optics
Metals Toxicology
Radiation Protection
Microbiology for Cancer
Real-time Heart Rate Variability
Microsurgery & Robotic Surgery
Remote Emergency Medicine Ultrasound
Military Medical Informatics
Reserve Component Medical Training
Miniature Renal Assist Devices
Resilience Training
Mitochondrial Disease
Respiratory Health
Molecular Signatures in Tumors
Retinal Display Technology
Mt. Sinai Cancer Research Program
Rett Syndrome
Multiple Myeloma
Rheumatoid Arthritis
Multiple Sclerosis
Scleroderma
Muscle Function
Segmental Bone Defects
Muscular Dystrophy
Sleep Disorders
Musculoskeletal Disorders
Sleep Management
Musculoskeletal Health
Smoking Cessation
Mustard Gas Antedote
Social Work Research
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Spinal Muscular Atrophy
Myotonic Dystrophy
Stem Cell Research
Nanomaterials for Bone Regeneration
Suicide Prevention
Nanomedicine for Drug Delivery Science
Sustained Release Drug Delivery
Natural Toxin Detection Technology
Tinnitus
Nephrotic Syndrome
Tissue Regeneration
Neuroblastoma
Trauma
Neurological Examination Equipment
Traumatic Brain Injury
Neuroprosthetics
Tuberculosis
Neuroscience
Vancomycin-resistant Enterococcus Infection
Non-opioid Pain Management
Vascular Malformations
Nutrition Optimization
Venus 3D Technology Program
Obesity-related Disease Prevention
Vitamin D
Orthopaedic extremity Trauma
Volume Angio CAT (VAC)
Osteoarthritis
Volumetrically controlled Manufacturing
Osteoperosis and related Bone Disease
West Nile Virus
Paget's Disease
Women's Heart Disease
Pancreatitis
Pathogenic-inactivated Blood Products
Pediatric Cancer
Peripheral Neuropathy

Source: CRS analysis of DOD, “About Us,” Funding History, accessed June 15, 2022, https://cdmrp.army.mil/
about/fundinghistory; and explanatory statements accompanying various DOD Appropriations Acts, FY1999-
FY2022.

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Appendix G. PRCRP Eligible Research Topics, FY2009-FY2022
Figure G-1. PRCRP Eligible Research Topics
FY2009-FY2022
FY2009 FY2010 FY2011 FY2012 FY2013 FY2014 FY2015 FY2016 FY2017 FY2018 FY2019 FY2020 FY2021 FY2022
Adrenal Cancer

Bladder Cancer







Blood Cancers








Brain Cancer






Cancer in Children, Adolescents and Young Adults






Cancers associated with the use of Beryllium

Cancers related to Radiation Exposure

Colorectal Cancer











Deployment-related Skin Cancer

Endometrial Cancer


Esophageal Cancer



Genetic Cancer Research





Germ Cell Cancer


Head and Neck Cancer



Immunotherapy





Kidney Cancer





Listeria Vaccine for Cancer








Liver Cancer








Lymphoma






Melanoma and other Skin Cancers







Mesothelioma












Metastatic Cancers



Myeloma


Myeloproliferative Disorders


Neuroblastoma










Non-Invasive Cancer Research using Nano Particles

Pancreatic Cancer








Pediatric Brain Tumors











Rare Cancers

Sarcoma


Scleroderma and Cancer Links

Stomach Cancer








Thyroid Cancer


Von Hippel-Lindau Disease


Source: CRS analysis of DOD, “About Us,” Funding History, accessed April 11, 2022, https://cdmrp.army.mil/about/fundinghistory; and explanatory statements
accompanying various DOD Appropriations Acts, FY1999-FY2022.
Notes: For FY2010 and FY2011, Congress appropriated funds for the PRCRP, however did not identify specific research topics.
CRS-24

Congressionally Directed Medical Research Programs: Background and Issues for Congress

Author Information

Bryce H. P. Mendez

Analyst in Defense Health Care Policy

Disclaimer
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Congressional Research Service
R46599 · VERSION 3 · UPDATED
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