Form 4 Online Survey

OMB C ontrol #: 0925-0668 - Expiration Date: 1/31/2016

NIH/NIAID/DMID Partnerships
Program Survey

Burden Disclosure: Public reporting burden for this collection of information is estimated to average 20 minutes
per response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not return the completed
form to this address.

Welcome!
You have been selected to participate in the external assessment of the NIH/NIAID/DMID
Partnerships Program, which was initiated in 2002 to support product-focused research and
development activities. Your participation in the survey is voluntary and you are free to skip any
particular question you do not wish to answer for any reason.
You will receive no direct benefits from participating in the survey; however, your responses will
provide critical data that will be incorporated into a summary report generated by an independent
contractor for NIAID. All information obtained in the survey will be reported in aggregate. A
designated NIAID External Partnerships Committee of senior academic and industrial
scientists/developers will use the report to prepare a formal assessment of the program with
recommendations for future directions and activities. There are no foreseeable risks of participating
in this survey. The information you provide will be kept secure to the extent permitted by law.
The survey should take approximately 20 minutes to complete. If you have received more than one
Partnerships award, please ensure that your responses are related to the award mentioned in your
survey invitation. If you are unable to finish the survey in a single sitting, you will be able to resume
the survey from the point where you stopped by selecting the link in the invitation email.
Thank you for taking the time to participate in this important program assessment. If you have any
questions about the survey, please feel free to contact us.
Michael Schaefer at [email protected]
Tina Parker at [email protected]
If you are 18 years of age or older, understand the statements above and freely consent to
participate in the survey, click on the "I Agree" link to begin the survey.

I Agree, launch survey.
I Do Not Agree

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OMB C ontrol #: 0925-0668 - Expiration Date: 1/31/2016

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Program Survey
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Which of the following best describes the general product (countermeasure) focus of your project funded by the award
referenced in your invitation email? (PLEASE SELECT ONLY ONE.)
Please use the 'Previous Question' button to navigate to earlier questions; do not use your browser's 'Back'
button.
Vaccine/Vaccine Technology/Adjuvant
Therapeutic
Diagnostic/Diagnostic Platform Technology
Immunotherapeutic
Research Resource/Service/Process
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OMB C ontrol #: 0925-0668 - Expiration Date: 1/31/2016

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What was the primary pathogen targeted in the project?

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If the Partnerships program was not available, would the project funded by the referenced award still have been
pursued?
No

Yes

Not Sure/Don't Know
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Overall, how important has Partnerships support been, or how important will it be, in research and development of this
candidate product, process, or service? (PLEASE SELECT ONLY ONE.)
Very Important
Important
Somewhat Important
Not Important
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OMB C ontrol #: 0925-0668 - Expiration Date: 1/31/2016

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Was there financial support from other sources for the project?
No

Yes

Not Sure/Don't Know
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Please identify the source(s) of parallel support:

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Which one of the following best characterizes the product, process, or service that was planned under this project?
(PLEASE SELECT ONLY ONE.)
A totally new product, process, or service
A new use for an existing product, process, or service
An improvement to an existing product, process, or service
A combination of products, processes, or services
Other
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Specify what else best characterizes the product, process, or service that was planned:

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Did Partnerships support provide technical validation (e.g., scientific concept vetted, proof of concept,
manufacturability)?
No

Yes

Not Sure/Don't Know
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Did Partnerships support provide data that led to acquisition of follow-on funding?
No

Yes

Not Sure/Don't Know
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Please identify the source(s) of follow-on funding:

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Did Partnerships support contribute to publications?
No

Yes

Not Sure/Don't Know
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Please provide citation(s):

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Did you develop an animal model, assay, reagent or product used by other investigator(s)?
No

Yes

Not Sure/Don't Know
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Please identify the animal model, assay, reagent or product developed:

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Please describe the purpose of the animal model, assay, reagent or product:

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Did the studies conducted with Partnerships support influence the decision to move forward?
No

Yes

Not Sure/Don't Know
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Please describe how the studies influenced your decision not to move forward:

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Please describe the most significant outcome of the supported research:

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Did the projects involve a candidate product (as evidenced by proof of principle)?
Examples of a candidate product include countermeasures against NIAID Category A, B, or C priority pathogens defined
as a vaccine, therapeutic, immunotherapeutic, diagnostic, adjuvant or related platform technology.
No

Yes

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Did Partnerships support advance a candidate product along the product development pathway?
No

Yes

Not Sure/Don't Know
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What was the developmental status of the candidate product prior to the award period? (PLEASE SELECT ONLY ONE.)
Basic Research
Early Translational (e.g., assay development, screening, target identification)
Translational (e.g., efficacy testing, model development, medicinal chemistry)
Preclinical Activities (e.g., safety, tox, production)
Pre-Investigational New Drug (Pre-IND)
Investigational New Drug (IND)
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What was/is the developmental status of the candidate product at the end of the award period? (PLEASE SELECT ONLY
ONE.)
Basic Research
Early Translational (e.g., assay development, screening, target identification)
Translational (e.g., efficacy testing, model development, medicinal chemistry)
Preclinical Activities (e.g., safety, tox, production)
Pre-Investigational New Drug (Pre-IND)
Investigational New Drug (IND)
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Was the candidate product acquired by, or licensed to, a partner/industry?
No

Yes

Not Sure/Don't Know
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Was there a transfer of technology/candidate product to other investigator(s)?
No

Yes

Not Sure/Don't Know
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Did Partnerships support contribute to pending intellectual property rights application?
No

Yes

Not Sure/Don't Know
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Did Partnerships support contribute to acquisition of intellectual property rights?
No

Yes

Not Sure/Don't Know
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Did Partnerships support contribute to FDA submission?
No

Yes

Not Sure/Don't Know
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Please identify what type of submission was made:

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Please provide the current status of the submission: (PLEASE SELECT ONLY ONE.)
Under FDA review
Product has FDA approval
Product is on clinical-hold
Other
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Please specify other current status of the submission:

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Did Partnerships support lead to a label change for new indication?
No

Yes

Not Sure/Don't Know
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What is the current status of the candidate product developed by the referenced Partnerships award? (PLEASE SELECT
ONLY ONE.)
Under development
Commercialization stage
In use by target population
Discontinued
Other
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Please specify the other status of the candidate product:

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Did the reasons for discontinuing development of the candidate product include any of the following? (PLEASE CHECK
ALL THAT APPLY.)
Idea failed due to insufficient efficacy
Idea failed due to inadequate safety margin
Market demand too small
Level of risk too high
Not enough funding
Company shifted priorities
Principal investigator left
No FDA approval
Licensed to another company
Product, process, or service not competitive
Other
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Please specify other reason for discontinuing development of the candidate product:

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Has the PI/company obtained any other NIH awards, in addition to the referenced award, for products, processes, or
services that are related to this project? (The awards may have different principal investigators, and they may have
come before or after the referenced award or from different NIH agencies.)
No

Yes

Not Sure/Don't Know
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Please list the NIH institute(s) from which the PI/company has obtained any other NIH awards. Remember, the awards
may have different principal investigators, and they may have come before or after the referenced award or from
different NIH agencies.

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Did you have an industrial partner for your Partnerships during the award period?
No

Yes

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Which of the following best describes this company's (or industrial partner's) major field of business? (PLEASE SELECT
ONLY ONE.)
Biotechnology
Pharmaceuticals
Diagnostics
Non-Profit
Healthcare
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What is the current status of the company (or industrial partner)? (PLEASE SELECT ONLY ONE.)
Actively engaged in the same business
Merged with another company
Sold
Closed
Other
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Please specify other current status of the company (or industrial partner):

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Thinking now just about the referenced award, how satisfied were you with your experiences going through the
Partnerships application, review, and award process.
How satisfied were you with obtaining information about the Partnerships program?
Very dissatisfied
Mostly dissatisfied
Mixed
Mostly satisfied
Very satisfied
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Not Applicable

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How satisfied were you with instructions for preparing applications?
Very dissatisfied
Mostly dissatisfied
Mixed
Mostly satisfied
Very satisfied
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Not Applicable

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How satisfied were you with the review process?
Very dissatisfied
Mostly dissatisfied
Mixed
Mostly satisfied
Very satisfied
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Not Applicable

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How satisfied were you with the award process?
Very dissatisfied
Mostly dissatisfied
Mixed
Mostly satisfied
Very satisfied
Skip this Question
Not Applicable

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How satisfied were you with the post-award administration?
Very dissatisfied
Mostly dissatisfied
Mixed
Mostly satisfied
Very satisfied
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Not Applicable

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Please provide any additional information about the Partnerships application, review, and award process that you think
may be helpful to us.
After entering your response, select "Submit Survey" to complete.

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Submit Survey

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Survey Complete!
Thank you for taking the time to participate in this important program assessment.
Michael Schaefer at [email protected]
Or
Tina Parker at [email protected]

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OMB C ontrol #: 0925-0668 - Expiration Date: 1/31/2016

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Program Survey

We are sorry that you have decided not to participate in our assessment of the NIH/NIAID/DMID
Partnerships program. If you change your mind, you can select the link in the invitation email to
complete the survey at a later date.
If you would like to complete the survey via telephone or paper survey, or if you would like to share
anything about your experience with the Partnerships program outside of the survey, please feel free
to contact us at:
Michael Schaefer at [email protected]
Tina Parker at [email protected]

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OMB C ontrol #: 0925-0668 - Expiration Date: 1/31/2016

NIH/NIAID/DMID Partnerships
Program Survey

Burden Disclosure: Public reporting burden for this collection of information is estimated to average 20 minutes
per response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA# 0925-0668. Do not return the completed
form to this address.

Click here to resume the NIH/NIAID/DMID Partnerships Program Survey.

Remember, your participation in this survey is voluntary and you are free to skip any particular
question you do not wish to answer for any reason. You will receive no direct benefits from
participating in the survey; however, your responses will provide critical data that will be
incorporated into a summary report generated by an independent contractor for NIAID. All
information obtained in the survey will be reported in aggregate. A designated NIAID External
Partnerships Committee of senior academic and industrial scientists/developers will use the report to
prepare a formal assessment of the program with recommendations for future directions and
activities. There are no foreseeable risks of participating in this survey.
If you have any questions about the survey, please feel free to contact us. The information you
provide will be kept secure to the extent permitted by law.
Michael Schaefer at [email protected]
Tina Parker at [email protected]

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