The SBIR program allocates 2.5 percent of 11 federal agencies’ extramural R&D budgets to fund R&D projects by small businesses, providing approximately $2 billion annually in competitive awards. At the request of Congress the National Academies conducted a comprehensive study of how the SBIR program has stimulated technological innovation and used small businesses to meet federal research and development needs. Drawing substantially on new data collection, this book examines the SBIR program at the National Institutes of Health and makes recommendations for improvements. Separate reports will assess the SBIR program at DOD, NSF, DOE, and NASA, respectively, along with a comprehensive report on the entire program.