The National Institutes of Health (NIH) awards additional funds for extramural research to support research infrastructure and administration, such that the total cost of a given research project depends on where it is conducted. We sought to understand whether greater indirects were associated with a greater scientific impact of NIH-funded work. The NIH RePORTER database was queried to retrieve all R01, R21, or R03-funded research proposals for which NIMH was listed as the primary funding source for proposals funded between 2012 and 2023. We applied multiple regression to examine the association between indirect rate and measures of scientific impact, including number of publications, their citation impact in terms of H-index per grant and total citations, and the number of patents associated with each grant. Of 5,143 projects, reflecting $9.85 billion, mean indirect rate was 47.9% (SD 16.2%). Greater indirect rate was associated with modest but statistically significantly greater number of publications (+0.30 per 10% increase in indirect rate, 95% CI 0.08-0.51); H-index at 5 years (+0.25 per 10% increase in indirect rate, 95% CI 0.18-0.33; Figure 1); and total citations (+29.71 per 10% increase in indirect rate, 95% CI 17.86-41.57). Each 10% increase in indirect rate was associated with a 20% increase in odds of patent filing (aOR 1.20, 95% CI 1.05-1.37). The results suggest small incremental benefits from conduct of research at higher-cost institutions and provide data for policymakers to consider in weighing the costs against potential benefits of work at such institutions.

Dr. Perlis has received fees for scientific advising from Belle AI, Genomind, Circular Genomics, Mila Health, Vault Health, and Alkermes, outside of the present work. He holds equity in Psy Therapeutics and Circular Genomics. He serves as Editor-in-Chief of JAMA Artificial Intelligence and Associate Editor at JAMA Network Open.

Dr. Perlis is supported in part by the National Institute of Mental Health (R01MH123804, U01MH136059). The sponsors did not contribute to the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Dr. Perlis had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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