NIH terminations disrupt 1-in-30 trials

The numbers in this story come from a research letter published in *JAMA Internal Medicine* on November 17, 2025, and then summarized by *The American Journal of Managed Care*. The authors found that 383 NIH-funded clinical trials lost grant support after a wave of terminations in 2025, equal to about 3.5% of 11,008 active NIH-funded interventional trials they examined. More than 74,000 enrolled participants were tied to those disrupted studies, and the terminated awards carried a cumulative value of $1.81 billion. Here’s the key point: this was not a story about a handful of stalled projects. The analysis describes a broad interruption across the clinical research system, touching 210 recipient institutions and multiple disease areas, with infectious disease trials hit hardest by topic area. Columbia was identified as the institution with the highest number of terminated grants in the AJMC summary of the paper. (jamanetwork.com) ### Where does the “1 in 30 trials” figure come from? The “1 in 30” shorthand is the rounded version of 3.5%. The researchers used NIH ExPORTER data to identify 11,008 active NIH-funded interventional trials during the study window, then matched those trials to grants that had been terminated. Of those, 383 trials were affected. (ajmc.com) The study period captured grant terminations between February 28 and April 8, 2025, while the trial universe included NIH-funded interventional studies active through mid-August 2025, according to coverage of the paper. That means the estimate reflects a defined slice of the 2025 cuts, not necessarily every disruption that may have followed. (jamanetwork.com) ### What exactly was disrupted when grants were terminated? Clinical trials depend on grant funding for staff, monitoring, follow-up, data collection and site operations. The paper describes trials as the main mechanism for evaluating medical interventions, and the surrounding coverage makes clear that the fallout was operational as well as financial. (ajmc.com) AP, published by PBS, reported that some participants may have enrolled in trials that were delayed or never started, while others could have lost access to study medication or been left with an unmonitored device implant. Heather Pierce of the Association of American Medical Colleges said “the disruption to the research enterprise was profound and substantial,” while co-author Anupam Jena said the trials were meant to generate evidence on what works in medicine. (jamanetwork.com) ### Which kinds of trials were most exposed? Infectious disease studies were the most affected by topic area, according to AJMC’s summary of the paper. The disrupted trials were also more likely to be conducted outside the United States and to test preventive or behavioral interventions, rather than other types of study designs. (pbs.org) The grant terminations themselves were concentrated in parts of NIH that had already drawn attention in the administration’s review of research priorities. AJMC reported that the National Institute of Mental Health and the National Institute on Minority Health and Health Disparities had the largest numbers of terminated grants. (ajmc.com) ### What did the administration say? Andrew Nixon, a spokesperson for the U.S. Department of Health and Human Services, said the NIH was realigning priorities and that funding was likely cut for trials that “prioritized ideological agendas over scientific rigor and meaningful outcomes for the American people,” according to AP. He also told Fierce Biotech that institutions receiving NIH grants remain responsible for standard clinical care for their patients. (ajmc.com) Researchers and former NIH officials disputed that framing. Jeremy Berg, a former NIH institute director, said the cuts could damage trust in the clinical trial system and discourage future participation. Lead author Vishal Patel told Fierce Biotech the pattern suggested terminations were not tied to research quality. (pbs.org) ### What should readers watch next? The paper itself was published online November 17, 2025, in *JAMA Internal Medicine*, and public tracking efforts have continued since then. A December 19, 2025 comment on the JAMA page pointed readers to tools called Trials Tracker and Grant Witness, which researchers said were built to monitor affected awards and studies in real time. (pbs.org) That next phase matters because the published estimate captures documented terminations, while JAMA commenters said the federal record remains incomplete and harder-to-track funding freezes may not be fully visible yet. (jamanetwork.com)