Oral Anticancer Agents: Utilization, Adherence, and Health Care Delivery (R21) | PA 17 061

Opportunity Information: Apply for PA 17 061

The Oral Anticancer Agents: Utilization, Adherence, and Health Care Delivery (R21) funding opportunity (PA-17-061) is a National Institutes of Health discretionary grant designed to support early-stage, exploratory, or developmental research on how oral anticancer medications are used in real-world settings. The central goal is to generate practical knowledge and testable approaches that improve how these therapies are delivered and taken, with the end result of better safety and stronger clinical outcomes. Because oral anticancer drugs shift a significant share of day-to-day treatment responsibility from clinics to patients and families, the FOA focuses on understanding where breakdowns occur across the full medication-use process, from prescribing and dispensing to patient education, monitoring, side-effect management, and ongoing adherence over time.

The FOA emphasizes three connected research aims. First, applicants are encouraged to assess and clearly describe the current state of oral anticancer medication utilization, delivery, and adherence. That can include documenting patterns of initiation, persistence, dose modifications, interruptions, discontinuation, and the practical realities of obtaining and managing these medications. Second, the FOA seeks studies that identify structural, systemic, and psychosocial barriers that interfere with adherence. This includes issues such as cost and insurance design, pharmacy access and dispensing practices, prior authorization delays, fragmented care coordination, health literacy challenges, language barriers, transportation constraints, stigma, mental health stressors, and family or caregiver burden. Third, the FOA calls for developing models and strategies that make delivery safer and more effective, such as workflow redesign, new care coordination approaches, adherence monitoring systems, patient and caregiver supports, and team-based interventions that can be tested and refined.

A key requirement is that applications anchor their research questions in at least one specific cancer type, class of drugs, and/or a population experiencing disparities. The FOA explicitly highlights disparity-relevant groups such as older adults, people with low socioeconomic status, and racial or ethnic minorities, but it also allows other disparity-focused groupings if well-justified. The intent is to push the field beyond general descriptions by examining how adherence and access challenges differ by disease context and by population, and by designing solutions that fit those contexts rather than assuming a one-size-fits-all approach.

The opportunity is broad in the level of analysis it supports. Projects may focus on pediatric, adolescent, or adult patients, as well as patient-caregiver dynamics, provider behavior, the broader health care team, or the health care delivery system itself. Methodologically, NIH encourages intervention studies, observational studies, and mixed-methods designs. For observational work in particular, the FOA stresses the importance of identifying modifiable risk factors that can directly inform later intervention research, rather than simply documenting associations that are not actionable. In practical terms, competitive projects would typically connect measurement of adherence and delivery problems with clear levers for change, such as communication practices, refill systems, toxicity monitoring, adherence supports, or policy and workflow adjustments.

As an R21 mechanism, the grant is intended for exploratory and developmental work rather than large definitive trials. The listed award ceiling is $200,000. The program sits within the NIH health and education funding activity area and is associated with CFDA number 93.395. The original closing date provided for this particular listing was 2018-01-24, and the FOA was created on 2016-11-28.

Eligibility is intentionally expansive to encourage diverse applicants and settings. Standard eligible applicants include state, county, city or township governments; special district governments; independent school districts; public and state-controlled and private institutions of higher education; federally recognized Native American tribal governments; public housing authorities/Indian housing authorities; Native American tribal organizations (other than federally recognized tribal governments); nonprofits with and without 501(c)(3) status (other than institutions of higher education); for-profit organizations (other than small businesses); and small businesses. The FOA also calls out additional eligible applicant categories that can be especially relevant for disparity-focused research and community-engaged projects, including Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISI), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, regional organizations, U.S. territories or possessions, and even non-U.S. (foreign) entities.

Overall, this grant opportunity is aimed at improving the real-world effectiveness of oral anticancer therapies by studying how people actually access, manage, and adhere to these medications, diagnosing why adherence fails at patient, provider, and system levels, and piloting practical delivery and adherence strategies that can be scaled or tested more rigorously in future research.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Oral Anticancer Agents: Utilization, Adherence, and Health Care Delivery (R21)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.395.
• This funding opportunity was created on 2016-11-28.
• Applicants must submit their applications by 2018-01-24. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $200,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

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