Category Archives: News Stories & Editorials

New Blood Tests for Early Cancer Detection Get Some Love From House Members

 Joyce Frieden, MedPage Today. September 18, 2025 •


House members seemed generally supportive Thursday of bills that would expand access to “breakthrough” medical devices, although Democrats complained that the focus on the topic was misguided at a time when the Trump administration and Congress are cutting funding for research on cancer and other diseases.

“We continue to fiddle in this subcommittee while Rome burns,” said Rep. Diana DeGette (D-Colo.), ranking member of the House Energy & Commerce Health Subcommittee, during a hearing on “Examining Policies to Enhance Seniors’ Access to Breakthrough Medical Technologiesopens in a new tab or window.” “We should be talking about the cuts to the NIH, FDA, CDC, and our nation’s other critical healthcare agencies. The committee should be examining directives from the administration that have delayed or completely halted critical work, and all of us should be talking about the impact this is having on our constituents.”

Rep. Marc Veasey (D-Texas) agreed. “Our healthcare system is being undermined right now in front of us, and American leadership and medical innovation, I believe, is on the line,” he said. “The [HHS] secretary has proposed cutting NIH funding by nearly half, and that will drag us back to 2007 levels. He’s pulling the rug from under researchers who make cancer breakthroughs possible, who run the clinical trials, and train the next generation of scientists. And those cuts are going to mean slower progress and higher costs and more Americans dying while waiting for cures that may never come.”

One of the bills discussed extensively at the hearing was the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Actopens in a new tab or window, which would require multi-cancer early detection screening tests to be covered by Medicare relatively quickly upon FDA approval. The bipartisan measure currently has 304 co-sponsors.

Subcommittee members heard from patient advocate Roger Royse about his experience with a blood test that can detect up to 50 different kinds of cancers. “In June of 2022 I took a … multi-cancer early detection test,” Royse said. “I had no symptoms … I thought I had no risk factors, but I did have one really big one, and that’s age — I was 62 years old at the time. The test came back positive … and within a couple weeks, I was diagnosed with stage IIb pancreatic cancer. At that time, the 5-year survival rate for pancreatic cancer was 12%; it’s currently 13%.” However, “as it turns out, mine was caught in an early stage and was localized, meaning that my survival rate instead of 13% was 44%,” he added.

[….]

fSubcommittee member Rep. Neal Dunn, MD (R-Fla.), a surgeon specializing in advanced prostate cancer, co-sponsored the bill. “The status quo for cancer detection in America today is simply unacceptable,” he said. “Each day, more than 1,400 Medicare beneficiaries receive the devastating news that they have advanced-stage cancers. Further, over 70% of cancer tests occur from cancer for which there is no routine screening. This demands our attention.”

“While practicing I certainly experienced firsthand the difference between early-stage and late-stage cancer diagnosis,” he said. “Simply put, when it’s caught early, patient outcomes are dramatically better. [This bill] offers us a chance to do just that.”

But not everyone at the hearing was completely on board. “As a cancer survivor, I appreciate that the goal of [this] bill is to save lives,” said Diana Zuckerman, PhD, president of the National Center for Health Research. “Multi-cancer early detection tests are so promising, but they’re not quite ready for prime time yet. The most recent research — in a study that just came outopens in a new tab or window this week — has concluded that the existing tests are subject to bias, miss most early cancers in people who do not have symptoms, and may provide false positives to most patients. In one of these tests, test results indicating cancer was correct only 4% of the time.” 

“I agree with the article on the American Cancer Society websiteopens in a new tab or window that a test with many false positives, where many patients who are told they may have cancer do not have cancer, causes anxiety and results in additional testing that may be painful, harmful, expensive, time consuming, and stressful,” she added. “A test with many false negatives, in which patients are told that they do not have cancer when they actually do have cancer, is likely to result in patients who ignore signs and symptoms of cancer and thus delay needed treatment.”

Another bill discussed at the hearing was the Expanding Access to Diabetes Self-Management Training Actopens in a new tab or window, which would allow allied health professionals to provide the self-management training, in addition to physicians. It also specifies that Medicare coverage includes an initial 10 hours of training as well as an additional 2 hours of training per year. The bill also prohibits CMS from limiting training that is deemed medically necessary.

Several subcommittee members spoke in favor of the measure, including DeGette, who added one caveat. “[This] is a great bill to help Medicare beneficiaries with diabetes take better charge of the disease,” she said. “As the co-chair of the diabetes caucus, I love this bill, but meanwhile, the Trump administration has proposed to eliminate the National Diabetes Prevention Program at CDC, a program that is proven to help people with pre-diabetes avoid progression to type 2 diabetes through lifestyle changes.”

The bills must be approved by the subcommittee before moving to the full Energy & Commerce Committee for a vote; those that pass will then be sent to the full House to be voted on.

To read the entire article, click here

FDA Leaders Moving to Abandon Advisory Committee Reviews of Specific New Drugs

KFF News, Arthur Allen, September 12-16, 2025


Under President Donald Trump, leaders at the US Food and Drug Administration (FDA) are moving to abandon a decades-old policy of asking outside experts to review drug applications, a move critics say would shield the agency’s decisions from public scrutiny.

The agency “would like to get away” from assembling panels of experts to examine and vote on individual drugs, because “I don’t think they’re needed,” said George Tidmarsh, head of the FDA’s Center for Drug Evaluation and Research. He relayed the message last week at a meeting of health care product makers and to an FDA advocacy group.

In addition to being redundant, Tidmarsh said, advisory meetings on specific drugs were “a tremendous amount of work for the company and for the FDA. We want to use that work and our time to focus on the big questions.”

The FDA’s advisory committees were created in their current form by a 1972 law aimed at expanding and regulating the government’s use of experts in technical decisions. They’re periodically summoned for advice, including to review evidence and vote on whether the FDA should approve drugs, vaccines, and medical devices, often when FDA officials face a difficult decision.

FDA actions have traditionally aligned with committee votes. A departure can provoke controversy and public debate, as was the case with the split 2021 decision on whether to approve the Biogen drug Aduhelm to treat Alzheimer’s disease.

The FDA approved the drug despite a “no” vote from its advisory committee, whose members felt the medicine did little to treat the disease. The conflict over Aduhelm laid bare the FDA’s struggle to reconcile pressure from industry and desperate patients with its rigorous evaluation of drug risks and benefits.

Tidmarsh said the committees would still be consulted on general issues like how to regulate different classes of drugs. But meetings on specific drugs, in which experts plow through piles of studies and hours of testimony from FDA and company officials, were mainly useful, he said, because they allowed the public to see how the FDA worked.

This month, the FDA began publishing the “complete response letters” it sends to companies when it declines to approve their products. Releasing the letters, which previously required filing requests under the federal Freedom of Information Act, promotes a level of transparency akin to the advisory meetings’, Tidmarsh said.

Advisory committee meetings on individual drugs “are redundant when you have the complete review letters,” he told KFF Health News in a brief interview after appearing at the health care products conference.

Former FDA officials and academics who study the agency disagree. The meetings help FDA scientists make decisions and increase public understanding of drug regulation, and abandoning them doesn’t make sense, they said.

Tidmarsh’s reasoning is “hard to follow,” former FDA Commissioner Robert Califf told KFF Health News. “It’s extremely useful for people inside FDA to find out what other experts think before they make their final decisions. And it’s important to do that in a way that enables the public to understand the points of view.”

“Experts might ask questions of the company or FDA that neither of them thought of on their own,” said Holly Fernandez Lynch, an associate professor of bioethics and law at the University of Pennsylvania. “The public has few other opportunities to comment about FDA decisions.”

Spokespeople for FDA and the Health and Human Services Department did not respond to repeated requests for elaboration on Tidmarsh’s comments.

Califf at times disagreed with advisory committees as commissioner of the agency and once floated the idea that it might be better if they deliberated but did not vote on products. Still, while “maybe someone can come up with a better one, I always thought it was an amazing system,” he said.

[….]

The advisory committees are “an important resource” for the FDA, said Sarah Ryan, a spokesperson for the Pharmaceutical Research and Manufacturers of America. “They can play an important part of the rigorous human drug review process we have in the U.S.”

[….]

The changes Tidmarsh described are already playing out on the ground. The FDA has held only seven advisory committee meetings since Trump reentered the White House, compared with 22 over the same time frame last year. Officials say they will now release complete response letters as they are sent, and published a batch of 89 earlier this month.

Makary has, to some extent, replaced the advisory committees, whose members have traditionally been vetted for expertise and biases and are required to deliberate in public, with panels of handpicked scientists who support his views on subjects such as hormone replacement therapy and antidepressants.

Diana Zuckerman, an FDA watchdog, attended the July hormone replacement therapy panel that considered the FDA’s black box warning listing dangers of the treatment. Makary had wanted the warning removed and packed the panel with like-minded experts.

The event was hastily called with no opportunity for the public to review discussion materials or comment on them, she said.

“All that was transparent was that they didn’t want to hear from anyone who disagreed with them,” said Zuckerman, who leads the National Center for Health Research.

Before becoming commissioner, Makary pushed for more advisory committee meetings. In early 2022, he blasted the FDA’s decision to approve COVID-19 boosters for children ages 12 to 15 without consulting its Vaccine and Related Biological Products Advisory Committee. Makary posted on the social platform X at the time, “It is a slap in the face to science for @US_FDA to circumvent the standard convening of the expert advisory board.”

But Tidmarsh seems to disagree.

Instead of asking an advisory committee to vote in favor of or against a Duchenne muscular dystrophy drug, for example, he said the FDA would be better served by a committee studying the best way to evaluate such drugs, such as which outcomes, or endpoints, to measure. “Is this endpoint correct for Duchenne muscular dystrophy? That’s an important question that cuts across many different companies,” he told KFF Health News.

FDA official Vinay Prasad canceled a planned July advisory committee meeting to discuss a Duchenne drug made by the biotech company Capricor Therapeutics. The FDA later published its complete response letter to Capricor, which then published its own letter of response to the FDA. Prasad was later pushed out and rehired with fewer powers.

An advisory committee meeting could have worked through the drug’s risks and benefits in a calmer, public, less politicized atmosphere, Ramachandran said.

[….] 

That’s why Tidmarsh’s comments “come as a complete surprise,” said Genevieve Kanter, an associate professor of public policy at the University of Southern California, who wrote commentary accompanying the study. 

[….]

“Another theory is that this decision is strategic,” she said, “in terms of consolidating power in the agencies so that you are no longer accountable to outside experts or the public.”

To read the entire article, click here https://www.cancertherapyadvisor.com/news/under-trump-fda-seeks-to-abandon-expert-reviews-of-new-drugs/

After 10 Years, the FDA Is Still Letting Women Down

By Michelle Llamas, BCPA August 14, 2025

In Drugwatch’s 2015 investigation, How the FDA Let Women Down, we highlighted issues with drug and medical device approvals that posed greater risks to women.

Now, we’re diving deeper into regulatory processes to highlight how far they’ve come — and where the administration still falls short in terms of device testing and clinical trials for medical products marketed toward women.

The FDA’s 510(k) clearance process is still allowing moderate-risk devices on the market without clinical trials. Some of these products, such as pelvic mesh, continue to hurt women.

The agency has also been working to approve drugs faster than ever, offering fast-track options for new drugs for serious illnesses such as cancer.

However, mistakes can lead to devastating outcomes when drugs are approved based on lower-quality data. In some cases, the FDA proposed using one clinical trial with patients instead of two to approve drugs faster.

More recently, the FDA has championed AI to help achieve faster drug approvals, but AI has been known to produce false data.

As health care evolves, so do women’s needs and safety concerns. Stronger data and testing requirements can help protect women from dangerous medical devices and drugs.

Medical Approval Processes May Fall Short

While the FDA requires clinical trials for drugs to hit the market, a large number of medical devices are sold without trial data — exposing women and men to health risks.

The 510(k) clearance process allows medium-risk (Class II) medical devices like surgical mesh, some hip implants, catheters, pregnancy tests and others on the market without clinical trials as long as they are similar to devices already on the market.

[….]

Drug approvals, on the other hand, require more testing and clinical data for the FDA to approve them. However, in some cases, the quality of the data submitted may be an issue, and drugs could be approved based on lower standards.

Medical Devices: Inadequate Testing, Conflicts of Interest and Delayed Warnings

Donna Miser’s doctor implanted a surgical mesh bladder sling that was supposed to help her with stress urinary incontinence (SUI), a condition that causes urine to leak when there’s increased pressure on the bladder. Exercising, sneezing or coughing can all trigger these leaks. SUI affects 1 in 3 women.

But no one told her about the risks of mesh.

The implant is supposed to be permanent, but after a few years, the mesh eroded into her bladder and vaginal walls and cut into her urethra in multiple places. She’s since had several surgeries to remove the mesh.

“Someone’s really dropped the ball. I do not understand how so many women got implanted with [this] product. That surgeon looked at me with a smile on his face, telling me, ‘I have got the answer. I’ve got the cure for you. We’re going to put this in you,’” Miser told Drugwatch. “It wasn’t tested. It wasn’t approved.”

[….]
When Miser said her mesh wasn’t tested or approved, she wasn’t wrong. The 510(k) process allows devices to be approved without clinical trials if they are similar to products already on the market, which are called predicate devices.

The issue with 510(k) approvals is that products can enter the market based on similarities to decades-old devices. This was the case with the surgical mesh implanted in women for SUI or pelvic organ prolapse (POP), a condition where organs slip down and bulge into the vagina.

Another, more rigorous (but less frequently used) path to device approval, Premarket Approval (PMA), requires more scientific evidence. The PMA is intended for high-risk Class III medical devices, such as pacemakers or defibrillators.

Mesh implanted through the vagina for POP has since been reclassified to a Class III device and now requires more testing before it’s sold, but SUI mesh remains a Class II.

[….]

“Missing Safety Device Data May Delay FDA Warnings

The FDA’s Manufacturer and User Facility Device Experience (MAUDE) system is a searchable database for medical device complications. The FDA uses it to flag safety data and determine if it needs to take action.

Madris Kinard of Device Events used to work at the FDA as an adverse events subject matter expert for devices and unique device identification (UDI). Kinard spoke to Drugwatch and cited a report on a problematic birth control device called Essure. With Essure, doctors implanted two metal coils into the fallopian tubes. This caused scar tissue to develop, blocking the tubes and preventing sperm from reaching the egg.

Women reported thousands of complications from Essure that led them to get it surgically removed.

Kindard’s FDA database analysis showed that about 32,000 device complaints from inspections of Essure’s manufacturer in 2011 and 2013 hadn’t made it into the FDA’s database. Kinard said it’s not clear whether these complaints contained adverse event reports because the details haven’t been made public. The FDA still hasn’t responded to her Freedom of Information Act (FOIA) request.

If that data had been added to MAUDE, it might have given the FDA more information to warn women about Essure sooner.

“That set them back by probably 10 years in identifying these problems,” Kinard said.

[…]

Drugs: Poor Evidence for Approval, Improper Doses for Women and Underrepresentation in Clinical Trials

Unlike the 510(k) clearance pathway for medical devices, drugs require more clinical trial data for approval. One of the most important parts of the drug approval process is when the FDA looks at the risks and benefits from clinical trial data submitted by a manufacturer. The FDA expects the manufacturer to conduct two well-designed clinical trials, but in some cases, it will accept one.

To determine if drugs work safely, the FDA uses four minimum criteria to judge whether manufacturers have provided enough evidence for drug approval.

A new report from The Lever and the McGraw Center for Business Journalism at CUNY’s Newmark Graduate School of Journalism analyzed a government database and looked at 429 drugs approved by the FDA from January 2013 to December 31, 2022.

The report revealed that the FDA approved these drugs without clinical trials that met the minimum four criteria of having a control group, blinding, replication or clinical endpoints.

“More medical products have been allowed on the market in the last decade based on skimpier research, or research studying biological markers that patients can’t feel (such as plaques on the brain or bone density) rather than meaningful health benefits such as living longer or spending less time in a hospital,” Diana Zuckerman, President of the National Center for Health Research and a project advisor for The Lever, told Drugwatch.

Investigative journalists Jeanne Lenzer and Shannon Brownlee spearheaded the database project and found several surprises in the data.

“We knew going in that the FDA had relaxed its scientific standards over the years and that the result was drugs getting on the market without adequate evidence that they work,” Lenzer told Drugwatch. “We didn’t know just how bad it was.”

Lenzer and Brownlee were also surprised by how many cancer drugs in the data they pulled made it to the market without adequate proof they work. The exact cancer medications are included in the table above.

[….]

Improper Dosing Can Lead to More Side Effects For Women

Women experience side effects nearly twice as often as men, and one of the reasons is that medications take longer to leave women’s bodies.

Even with researchers recommending dose reductions for women, the FDA hasn’t taken meaningful action to require sex-specific dosing information on drug labels.

One study in Biology of Sex Differences looked at 86 drugs and found that (when compared to men), women generally had higher blood concentrations of the drugs, and the medications took longer to leave their bodies. This led to higher rates of side effects in women in 96% of cases.

The findings in this study suggest that women may have been prescribed higher doses of drugs than necessary, even when they take the dose recommended on the drug’s label or as directed.

Medications studied included common OTC and prescription medications such as aspirin and Zoloft (sertraline).

[….]

Older Women and Women of Color Still Underrepresented

When we interviewed Zuckerman in 2015, she highlighted the lack of women, people of color or people over age 65 in clinical trials. Over the past 10 years, the FDA has increased the number of women in clinical trials, but still lags behind with women of color and older women.

“Most trials submitted to the FDA include quite a few women, but they are not women of color or women over 65, even though many diseases are more common on people over 65 and at least as prevalent in people of color,” Zuckerman told Drugwatch.

While it’s great that more women are finally included in trials, the benefits might not be seen for a few years. Most drugs on the market today were approved during older clinical trials. The data from these trials were primarily gathered from men, leaving a gap in safety data for women.

Expert Opinion: How Can the FDA Improve Drug Safety?

When it comes to drug safety, the FDA needs to require more stringent clinical trial evidence before allowing drugs onto the market.

“The problem for the agency is it is now hamstrung by Congress, which has, over the years, steadily eroded the statutes governing drug regulation,” Lenzer said. “In addition, we believe that PDUFA has to be repealed.”

The PDUFA, or Prescription Drug User Fee Act, allows the FDA to collect fees from drugmakers in exchange for expediting their medications’ reviews and approvals.

“Nobody wants to talk about that because it would almost certainly require public funding, but an agency that is paid by the industry it is supposed to regulate — almost by definition — cannot be independent. What that means for the FDA is it no longer protects the public health and patients because it’s too busy protecting the commercial interests of its benefactors,” Brownlee added.

[….]

This excellent article has many examples of specific medical products that are unsafe, and provides more information about what needs to be done.  You can read the entire article at https://www.drugwatch.com/featured/fda-still-letting-women-down/

Medical device industry says future MDUFA hikes unsustainable

Elise Reuter, MedTech Dive, August 5, 2025


Medical device companies advocated against future increases to user fees at a public hearing Monday for the next medical device user fee amendments. Meanwhile, Food and Drug Administration leaders, facing congressional budget cuts, made a case for more user fees, emphasizing the importance of the program.

The five-year agreement determines the amount the FDA can raise from the medtech industry to supplement congressional appropriations. In the current MDUFA program, which ends in September 2027, the FDA’s device center negotiated a boost in user fee funding in exchange for meeting certain review timelines and staffing levels. The next agreement would take effect in October 2027 and run through 2032. 

Michelle Tarver, director of the FDA’s Center for Devices and Radiological Health, said the FDA “requires sustained and increased investment by the medical device industry” to meet its goals. The device leader added that “holding steady does not lead to excellence — it leads to mediocrity.”

However, device industry lobbyists at the meeting indicated a preference for few changes.

“Each MDUFA cycle included significant resources and investments, including increasing the number of [full-time employees] to support the program,” said Janet Trunzo, senior executive vice president of technology and regulatory affairs for AdvaMed. “Now that we have approached nearly 25 years … of user fee programs for medical devices, we are now in a position of merely fine-tuning the current program.”

Mark Leahey, CEO of the Medical Device Manufacturers Association, called for the process to return “back to the basics” in comments on Monday. Leahey said the funds from MDUFA should go to reviewers and medical officers, and added that the industry wants more visibility as to where the funds are going and “where people are right now, realizing there’s been some attrition over the last six months.”

Citing the latest user fee rates, Leahey said more than $427 million in fees were authorized for fiscal year 2026.

“We have to realize the size and scope of the investments here,” he said. “And this is not a sustainable pathway.”

The meeting kicked off a process where the FDA will seek public comment through Sept. 4, before beginning negotiations with industry. When a final agreement is reached, the FDA will present it to Congress, which must approve the next MDUFA program.

[….]

Patient advocates call for more fees, transparency

While industry pushed back against further fee increases, patient groups called for more fees to offset federal budget cuts to the FDA. Diana Zuckerman, president of the National Center for Health Research, said that given recent cuts in FDA staffing and the importance of speedy device reviews, “it’s inevitable that improving quality requires increasing the fees.”

Zuckerman said that while she would like to see Congress provide enough appropriations for the FDA’s device center, “we want to make sure that there’s funding for everything that’s needed, and, unfortunately, appropriations isn’t making that possible.” 

Zuckerman also called for user fees to be used for postmarket device safety, as well as for more transparency during the negotiation process, positions that were supported by other patient advocates during the meeting. 

In the past, user fee negotiations have been behind closed doors, and patients, consumers and health professionals have not been able to join or observe the meetings, Zuckerman said. In the last round of negotiations, the FDA also faced scrutiny for not publishing meeting minutes from its conversations with industry in a timely fashion. 

“At the very least, we should have access to remotely watch those negotiations, instead of just depending on minutes that are often vague or very delayed so that stakeholders have no opportunity for meaningful input,” said Tess Robertson-Neel, on behalf of the Patient, Consumer, & Public Health Coalition, a group of more than two dozen nonprofits. 

Robertson-Neel added that user fees should be increased, and the FDA should focus on being “more patient-centered and transparent and less cozy with industry.”

Alexander Naum, policy manager for Generation Patient, a nonprofit representing young adults living with chronic medical conditions, said that user fees must increase and the next MDUFA agreement should include clear postmarket device safety performance goals. He also asked for the FDA to commit funds to expanding its program for tracking medical device adverse events. Naum cited a statistic that the FDA receives more than 2 million reports annually of suspected device malfunctions, serious injuries or deaths.

“So many of us rely on medical devices for our survival,” Naum said.  “Many of these devices present the potential of unexpected adverse events.”

Read the article in MedTech Dive here.

RFK Jr.’s Planned Assault on Corporate Influence Is Clashing With Reality

Margaret Manto, NOTUS, June 26, 2025


Health Secretary Robert F. Kennedy Jr. has made ending “corporate capture” of the federal health agencies a key tenet of his plan to eradicate what the MAHA Commission Assessment describes as “threats to American childhood that have been exacerbated by perverse incentives.”

But health care lobbyists, regulatory experts and advocates for reduced industry involvement all told NOTUS the same thing: So far, Kennedy’s words don’t match his actions.

“The rhetoric is quite different, but it doesn’t seem like the reality is obviously different,” said Diana Zuckerman, president of the National Center for Health Research, who has criticized the Food and Drug Administration’s funding structure that relies on collecting fees from the companies whose products it regulates. “There’s all kinds of conflicts of interest that have been absolutely ignored by HHS and, as far as we can tell, still are.”

Since ascending to the top of the U.S. public health system, Kennedy has made grand gestures towards his supposed goal of clamping down on corporate influence at the Department of Health and Human Services. He’s held press conferences to tout agreements made with food producers to end the use of certain synthetic food dyes and with insurance companies to speed up the prior authorization process, both of which companies have lobbied against for years.

But these agreements have all been entirely voluntary. In the case of the food dye announcement, that was a direct result of industry influence, said one lobbyist granted anonymity to speak frankly.

“Their biggest win was not real,” the lobbyist said.

[….]

“Secretary Kennedy’s commitment to eliminating undue corporate influence and restoring public trust in health policy is backed by decisive action. Under the Secretary’s leadership, HHS has taken concrete steps to increase transparency, strengthen ethical standards, and prioritize the health and well-being of the American people over industry profits,” the spokesperson wrote.

But the MAHA report, which took aim at a range of public health interventions that the MAHA movement is suspicious of, including vaccines and ultraprocessed foods, was noticeably light on criticism of the agriculture industry and pesticide use — which Kennedy has pledged to reform.

In a hearing last month before a subcommittee of the Senate Committee on Appropriations, Kennedy assured senators that he would “not do anything to jeopardize that business model.”

Other than reworking their pitches to use new, more MAHA-friendly language, companies and the lobbyists who work for them haven’t had to do much to adapt to the new HHS leadership, the lobbyist said.

“I haven’t noticed anything different at all,” they said. “I don’t know anybody who’s had a problem getting a meeting.”

[….]

Since these meetings, HHS has embarked on policies that both advance the MAHA movement’s public health goals and provide potential benefits to industries deemed acceptable.

Earlier this month, STAT News reported that HHS put out a call for proposals for a “bold, edgy” public messaging campaign to “inspire and empower Americans to reclaim control over their health.” The request specifically asks for proposals that highlight health wearables as “cool, modern tools.”

“My vision is that every American is wearing a wearable within four years,” Kennedy said during a congressional hearing this week.

Other policy decisions seem poised to benefit not just certain niches of the health care industry, but key players within the MAHA movement. In early June, the Food and Drug Administration declined to contest a court ruling that overturned a 2024 FDA rule regulating laboratory-developed tests.

The agency had previously argued that increased regulation was necessary to “better protect the public health by helping to assure the safety and effectiveness” of tests that are manufactured and used by a single laboratory, as opposed to commercially available in-vitro diagnostics that are used by labs nationwide and which the FDA requires to be thoroughly verified and validated.

[….]

The FDA is the main arbiter of which drugs, medical devices and food additives are allowed to enter the U.S. market. It has long borne the brunt of Kennedy’s and other HHS critics’ “corporate capture” accusations thanks to its user-fee funding structure, where companies pay to have their products reviewed by the FDA and help supplement the agency’s congressionally allocated funds.

Corporate influence watchdogs are scrutinizing other recent FDA shifts, too.

While FDA commissioner Marty Makary promised “radical transparency” during his confirmation process, earlier this month he announced a nationwide “listening tour” where he will meet with pharmaceutical and biotech CEOs to solicit their input on “how the FDA can modernize its regulatory framework to better support innovation and patient access to safe and effective therapies.”

Companies are required to have an active drug or device application with the FDA in order to send a representative to meet with Makary.

“The listening tours usually actually involve listening to the public, not just listening to each other,” said Zuckerman. “In the past they’d have it at some university or medical center or something, a public meeting. Anybody could sign up to attend, anybody could sign up to ask questions or make comments.”

The HHS spokesperson said the listening tour is intended to “break through the bureaucratic echo chambers that have long hindered the FDA” and that “direct engagement with regulated industry is essential for real reform and accountability.”

Makary also recently announced a new “Commissioner’s National Priority Voucher” program that would speed up the FDA review process for companies whose products “enhance the health interests of Americans.”

Reshma Ramachandran, a professor of medicine at Yale University who studies the influence of pharmaceutical companies, said the new voucher would likely worsen the existing conflict of interest issues at the FDA. She pointed to the shorter review time and deep personnel cuts at the agency as issues that would increase the FDA’s reliance on what the companies themselves say about their products.

“Will FDA have enough capacity to even push back against companies?” Ramachandran said.

HHS’ spokesperson disputed this characterization, saying that the National Priority Review Voucher program is about urgency, not favoritism.

“Expediting reviews for high-impact products does not compromise scientific integrity — it enhances timely access to innovations that can save lives,” they wrote.

One industry expert said he felt that both could be true at the same time.

“The National Priorities Voucher initiative at FDA goes right to the top of my lists of things that make you go ‘hmmm,’” said Steve Grossman, a regulatory consultant and co-founder of the Alliance for a Stronger FDA. “I like the boldness in thinking about FDA’s contribution to public health, the clear commitment to quicker decisions by the agency and the good sense of starting with a pilot program. At the same time, I worry about diluting the focus on unmet medical needs, the subjectivity of who receives the vouchers and the potential manpower crunch.”

Makary also announced earlier this year that the FDA would limit industry representation on FDA committees to what was “statutorily allowed” — something that Zuckerman said has been “pretty much true for years.”

While changes to committee membership may get plenty of attention, “there’s a much bigger universe of ways in which industry interfaces with HHS and all its subsidiary agencies,” said Matthew McCoy, an assistant professor of Medical Ethics and Health Policy at the University of Pennsylvania who studies conflicts of interest.

“It’s not as if that’s the only way in which industry influences can shape the way that policy making happens within these health care agencies,” said McCoy.


Margaret Manto is a NOTUS reporter and an Allbritton Journalism Institute fellow.

CORRECTION: An earlier version of this story misstated Steve Grossman’s title. He is a regulatory consultant and co-founder of the Alliance for a Stronger FDA.

 

In Vague Announcement, FDA Says It Will Cut Ad Comm Conflicts

Jessica Karins and Maaisha Osman, Inside Health Policy News, April 17, 2025


FDA will not allow experts who are employed by regulated industry to serve on advisory committees, the agency said in an announcement Thursday (April 17), but though the statement was framed as a change in policy, one expert said it was similar to FDA’s existing policy and so vague as to be “an announcement of nothing.” Another researcher, however, said the move come signal an attempt to add voices to advisory committees who are less qualified but ideologically aligned with the Trump administration.

In its Thursday statement, FDA said it was announcing “a policy directive that limits individuals employed at companies regulated by the U.S. Food and Drug Administration, such as pharmaceutical companies, from serving as official members on FDA advisory committees, where statutorily allowed.” The statement also said FDA will “prioritize and elevate the role of patients and caregivers, strengthening the voices of their communities.”

“Industry employees are welcome to attend FDA advisory committee meetings, along with the rest of the American public, but having industry employees serve as official members of FDA advisory committee members represents a cozy relationship that is concerning to many Americans,” FDA Commissioner Marty Makary wrote. “In fact, the FDA has a history of being influenced unduly by corporate interests.”

The announcement said employees of regulated industry can still serve on advisory committees when required by statute, and that “exceptions can be made in rare circumstances (i.e., when the scientific expertise in an area is only available from an employee of an FDA-regulated company) provided that the official strictly complies with the applicable ethics requirements.”

To Diana Zuckerman, president of the National Center for Health Research — an organization that has been critical of FDA advisory committees–the new policy sounded much like the existing policy.

Zuckerman said she’d like to see less industry influence on advisory committees. “It would be great if this is a new day, but it’s just not clear,” she said.

FDA advisory panel members are typically not employees of regulated companies, with the exception of industry representatives, who do not vote. Most expert members are physicians and academics, and most panels include at least one patient, consumer or caregiver representative; these members typically do not vote.

[….]

Zuckerman said the impact of the policy will depend on multiple factors not made clear in the announcement, including whether FDA will also exclude from committees experts who have non-employment relationships with regulated companies. Those relationships, such as past consulting work, research funding or payments for licensed inventions, have been frequently criticized by Kennedy in the past.

At press time, HHS had not responded to Inside Health Policy’s questions on whether these relationships will be included.

Zuckerman also said the allowance for employees of regulated companies to serve on an advisory committee if deemed necessary makes the implications of the announcement more unclear.

Additionally, Zuckerman said, the announcement doesn’t mention other conflicts of interest FDA traditionally hasn’t recognized — such as cases in which a physician has prescribed a product in the past for which safety is now being reevaluated and is worried about being sued, or a physician whose livelihood depends in part on a medical product being examined, such as a plastic surgeon who frequently provides breast implants.

Patients can also have conflicts of interest, Zuckerman said, and the patients FDA typically hears from — whether as patient representatives, consumer representatives or speakers during public comment periods — tend not to be those who have been harmed by medical products.

Michael Abrams, a senior researcher at Public Citizen Health Research Group, said the shift from FDA is opaque but potentially dangerous.

“I think it may be a veiled pretext for RFK Jr. to dissolve existing advisory committees, regardless of membership conflicts, and replace them with individuals who are less scientifically accomplished and adept, but who share the new HHS Secretary’s . . . world view,” he told IHP.

[….]

Abrams also pointed to the practical implications of dismantling or overhauling the current committee system, especially amid recent FDA staffing and budget cuts.

[….]

— Jessica Karins (jkarins@iwpnews.com), Maaisha Osman (mosman@iwpnews.com

To read the entire article, click here.

Canadians could lose vital safety information amid deep cuts to the U.S. FDA, experts warn

Annie Burns-Pieper, CTV News, April 13, 2025


Canadian health experts warn the fallout from thousands of job cuts at the U.S. Food and Drug Administration on April 1 could disrupt the flow of safety information on drugs, medical devices, and food to Canada.

For years, Canadian agencies responsible for monitoring food and pharmaceutical safety have worked closely with regulators around the world. The U.S. Food and Drug Administration’s (FDA) vast resources and global influence have played a role in informing decisions in Canada on issues such as safety warnings and recalls of dangerous foods and drugs from the market.

However, sweeping changes to the FDA since U.S. President Donald Trump took office could impact the benefits Canada derives from this historic collaboration, reducing the quality and availability of information about harmful drugs and food products—potentially allowing serious health risks to go undetected and products to remain on the market longer.

The U.S. Department of Health and Human Services (HHS), now headed by Robert F. Kennedy Jr., laid off 10,000 workers as part of Elon Musk’s Department of Government Efficiency task force. The department plans to cut 3,500 jobs directly from the FDA.

A ‘huge problem’

While a memo on the restructuring claimed that layoffs wouldn’t affect reviewers or inspectors of drugs, medical devices, or food, reporting in the U.S. revealed that these areas are being impacted. Reported job losses include lab scientists who tested food for contaminants including deadly bacteria, scientists at drug safety labs, and staff in the drug inspections and investigations office, among many others.

“I think this is a huge, huge problem,” said Matthew Herder, a professor of law and medicine at Dalhousie University who specializes in regulation of pharmaceuticals. He told CTVNews.ca in an interview that Canada has long benefited from the FDA’s size and reach.

[….]

Canada has historically benefited from U.S. post-market surveillance—the ongoing monitoring of drugs and medical devices after they’ve been approved—to detect safety issues that may not have surfaced during clinical trials. “They just have vastly more resources,” said Herder. “The chances of us picking up something before the U.S. are very slim.”

For example, in 2017, Health Canada issued a safety review and letter to health professionals for commonly used antibiotics, fluoroquinolones, following a review by the FDA, warning of a potential risk of “disabling side effects” from tendonitis or nerve damage.

In 2019, Health Canada recalled surgical mesh for transvaginal repair of pelvic organ prolapse following a U.S. recall. Canadian women had reported debilitating side effects, including urinary problems, mobility challenges, emotional distress, and discomfort during sex associated with this medical device.

Diana Zuckerman, the president of The National Center for Health Research in Washington, D.C, called the staff cuts at the FDA a disaster: “you can’t cut 20% of their staff and think it’s not going to have a tremendous impact.”

She said in an interview with CTVNews.ca that post-market surveillance is already under-resourced and worries it will be weakened further by the cuts.

Herder said less surveillance of approved drugs is particularly concerning given the trend in recent years of letting more drugs into the market with less evidence. “If we’re losing the oversight that the FDA offers globally or losing even the percentage of it, that is really terrifying.”

CTVNews.ca asked Health Canada, responsible for drug and medical device safety, about the concerns raised by experts that a diminished FDA could pose risks to Canadians, but the agency declined to comment.

Canadian outbreaks could ‘go totally unnoticed’

Canada has also long collaborated with American agencies for food safety. Keith Warriner is a food safety professor in the Department of Food Science at the University of Guelph. Despite the Buy Canadian movement, he believes imports from the U.S. will continue to be a significant source of food in Canada.

He said American agencies, including the FDA, Centers for Disease Control and Prevention, and the United States Department of Agriculture, have been particularly good at surveillance, and Canadians have benefited from information sharing.

“When an outbreak occurs, they’re pretty hot on it. In Canada, we could get outbreaks that go totally unnoticed,” Warriner told CTVNews.ca. Often recalls and alerts originate with American products and are adopted in Canada, meaning that a delayed response in the U.S. could also impact Canadian consumers.

His biggest concern about the changes to the FDA is that the U.S. might reduce food safety surveillance, and “if they cut back on that, then it’d be outbreaks running rampant.” He suspects the deep cuts will lead to fewer recalls due to a decrease in outbreak detection.

[….]

Dr. Joel Lexchin is concerned that, given the climate of U.S.-Canada relations, pharmaceutical information sharing could be reduced. The retired emergency room doctor and a former professor at York University who has been researching pharmaceutical policy in Canada for more than 40 years told CTVNews.ca, “if the FDA keeps data to itself, unsafe products may remain on the Canadian market for longer than they currently do.”

He would like to know how the historically collaborative relationship between the FDA and Health Canada is currently operating and how Health Canada plans to fill in any gaps left by potential changes in information sharing.

[….]

To read the entire article in CTV News, click here https://www.ctvnews.ca/health/article/amid-deep-cuts-to-the-us-fda-experts-warn-canadians-could-lose-vital-safety-information/

RFK Jr. brings FDA under tighter control with HHS workforce cuts

Lizzy Lawrence, Sarah Todd, and Matthew Herper, STAT NewsMarch 27, 2025


WASHINGTON — Around 3,500 employees are on the chopping block at the Food and Drug Administration, but they don’t yet know who they are.

The Health and Human Services Department on Thursday announced a sweeping plan to cut 10,000 jobs and consolidate operations across its sub-agencies. FDA drug, medical device, or food reviewers and inspectors will not be among those fired, according to an HHS fact sheet. Instead, the cuts will target employees working on policy, human resources, information technology, procurement, and communications. The administration will start sending notices to employees on Friday, with the terminations coming into effect on May 27.

The sparing of FDA reviewers may put some industry leaders at ease, but other FDA experts are concerned that firing the thousands of employees supporting their work will make it more difficult for the agency to promote innovation and protect public health. The layoffs will shrink the FDA by almost 20%.

“Even though the intent is not to affect product reviews or or inspections, inevitably, by cutting back on services, there will be an impact,” said Wayne Pines, former associate commissioner for public affairs for the FDA.

The cuts align with Elon Musk and the U.S. DOGE Service’s mission to trim the workforce. But they also represent HHS Secretary Robert F. Kennedy Jr.’s goal to exert more control over the sub-agencies he oversees. Even high-level FDA officials appear not to have been briefed on the cuts, sources told STAT, indicating a tightening of command within HHS. The power shift is clear on the media side, as STAT’s media requests continue to be redirected from FDA to the HHS press tea

[….]

This is not the administration’s first attempt to shrink HHS. In February, Musk laid off thousands of probationary workers, including people working on food safety, AI regulation, and preventing the spread of infectious diseases. After pushback from the device industry, the administration rehired some FDA reviewers a week later. A federal judge has since paused all the probationary layoffs. The administration has also offered civil servants $25,000 to leave their posts, and instated a strict work-in-office work policy that has alienated some employees.

Several employees at FDA have told STAT that morale is extremely low, particularly given the agency’s leadership vacuum. The Senate on Tuesday confirmed Marty Makary as FDA commissioner, but he hasn’t yet been sworn into the role. Lawmakers pressed Makary at his confirmation hearing about the DOGE cuts at the FDA, urging him to personally assess personnel before any major culling of the agency.

“If confirmed as commissioner, you have my commitment that I will do an assessment of the staffing and personnel at the agency,” Makary said. It is unclear if he will get the chance.

[….]

Pines noted that efforts to consolidate HHS and FDA are not new; as the former head of communications, he’s witnessed several reorganizations. But he said the level of consolidation is unprecedented, and could significantly impact the way FDA operates.

“The concept of consolidation, every secretary has had their point of view about that,” Pines said. “But there’s never been a change like this at FDA anywhere near this scale.”

The cuts seem “too big, too fast. I agree with RFK Jr., who says this is going to be painful, and I’m not sure what the rewards are going to be,” said Diana Zuckerman, a former congressional investigator for FDA approval standards and president of the nonprofit think tank National Center for Health Research. “These kinds of changes usually are extremely disruptive and not productive for at least a few years.”

Zuckerman wondered whether the cuts will ultimately impede Kennedy’s ambitions to reshape U.S. regulation of food. Kennedy has said he wants to focus on food labeling and fixing the “generally recognized as safe,” or GRAS, loophole in FDA review of food ingredients, as well as improving the quality and supply of infant formula

“I think those are important,” Zuckerman said. “Who’s going to do that?” Even if the people working on those specific issues are not affected by the cuts, “usually you’d need more people working on those kinds of issues.” 

Around 46% of the FDA’s total budget comes from “user fees” paid by industry to speed up product reviews. The FDA can use this money to fund employees who review medical product applications, conduct research to speed up regulatory decisions, inspect facilities, and evaluate products’ safety after they hit the market. The HHS reduction in force will likely spare most of these employees.

But the cuts won’t make their lives any easier. One FDA employee told STAT they are starting to lose access to medical journals they rely on for regulatory research. Gutting administrative personnel and cutting down on agency resources may slow down reviewers and worsen morale.

“Eliminating those people, it’s just going to be more difficult from a personnel perspective,” said Brian Ravitch, a regulatory consultant at Olsson Frank Weeda who worked for the FDA for 25 years.

To read the entire article, click here https://www.wsj.com/politics/policy/rfk-jr-plans-10-000-job-cuts-in-major-restructuring-of-health-department-bdec28b0

Pfizer hires FDA drug regulator Cavazzoni, sparking revolving door debate

David Lim, PoliticoFebruary 24, 2025


Pfizer has tapped the FDA’s former top drug regulator, Dr. Patrizia Cavazzoni, as its chief medical officer, the pharmaceutical company announced on Monday.

Allies of the new health secretary, Robert F. Kennedy Jr., seized on the news, pointing to Cavazzoni’s hire as proof of the revolving door with industry that Kennedy has long alleged is corrupting the FDA’s priorities and preventing it from taking a more skeptical view toward vaccines and other drugs.

“This is the core rot in American regulation,” Dr. Vinay Prasad, a professor at the University of California, San Francisco who is in the running for a job in Kennedy’s department, wrote in a blog post. “I find this behavior abhorrent, and it should be criminal. Mr. Kennedy has vowed to stop this, and I welcome that.”

The hire also drew criticism from public health advocacy groups that aren’t aligned with Kennedy.

“Cavazzoni’s move demonstrates that the revolving door between the FDA and the industries it regulates is alive and well,” said Dr. Robert Steinbrook, the director of Public Citizen’s Health Research Group.

Before joining the FDA in January 2018 as the deputy director of operations in the agency’s Center for Drug Evaluation and Research, Cavazzoni worked at Pfizer leading clinical sciences and development operations.

[…]

Cavazzoni will formally start the new role on March 1, according to Pfizer spokesperson Amy Rose. She will report to Dr. Chris Boshoff, Pfizer’s chief scientific officer and president of its research and development arm. Endpoints News and STAT first reported news of Cavazzoni’s new job.

Diana Zuckerman, the president of the National Center for Health Research, a nonprofit, said she’s watching to see who chooses Cavazzoni’s permanent replacement as the nation’s top drug regulator: Trump’s pick to lead the FDA, the as-yet-unconfirmed Johns Hopkins University surgeon Dr. Marty Makary, or Kennedy, a longtime critic of vaccination, or someone else in the administration.

“This is the problem with this revolving door at FDA, people go from industry to FDA and then while they are at FDA they still seem to be strongly aligned with industry and then when they leave FDA they go back to industry,” Zuckerman said. “It raises a lot of questions about how objective they are when they are supposed to be working for the public at the FDA.”

 

Read the article in Politico here: https://subscriber.politicopro.com/article/2025/02/pfizer-hires-fda-drug-regulator-cavazzoni-sparking-revolving-door-debate-00205735?site=pro&prod=alert&prodname=alertmail&linktype=article&source=email.

FDA webpages on clinical trial diversity removed after Trump orders

Elise Reuter, MedTech Dive, Jan. 27, 2025


Two days into the Trump administration, several webpages covering diversity in clinical trials, annual medical device reports and LGBTQ+ information were removed from the Food and Drug Administration’s website. It’s not clear if the changes are temporary or if the pages will be restored.

When asked about the removed webpages, an FDA spokesperson directed MedTech Dive to contact the Department of Health and Human Services. The HHS did not respond to multiple requests for comment.

It is definitely not typical,” said Diana Zuckerman, president of the National Center for Health Research. “From one administration to another, certain things are reviewed and taken down. I don’t think ever [in] the first week of the administration.” 

Other federal websites have scrubbed pages on diversity, equity and inclusionmentions of the acronym LGBTQ+federal policies on people with disabilities and abortion search results, according to reporting by Politico, NBC News, the Washington Post and NPR. The Trump administration has also frozen health research grants, according to STAT News.

Some of the removed FDA pages related to efforts around diversity, gender and health equity.

“Surely there’s someone who’s knowledgeable enough about science to understand the importance of diversity in clinical trials,” Zuckerman said of the Trump administration. 

recent draft guidance from the FDA’s Center for Devices and Radiological Health providing recommendations for medical device sponsors to consider sex- and gender-specific data in clinical studies was removed. The guidance was released on Jan. 6, and the page was last archived to the Internet Archive’s Wayback Machine on Jan. 14. As of Monday, the guidance was available through the Federal Register’s website.

Last week, President Donald Trump issued a raft of executive orders targeting DEI programs. One order called for the removal of federal DEI mandates, policies, programs, preferences and activities “under whatever name they appear.” Trump also issued an order stating that official U.S. policy recognizes two sexes as assigned at birth, male or female. The order contradicts medical groups, including the American Medical Association, that recognize sex and gender identity as a spectrum.

Although guidances are not legally enforceable, “it is troubling that this is happening,” said Michael Abrams, a senior health researcher at consumer advocacy nonprofit Public Citizen.

Most of the information in the guidance was “common sense,” said Madris Kinard, CEO of Device Events, a company that tracks the FDA’s adverse event reports and recalls.  “This is research on making sure you include the right populations that are relevant to the device that you’re approving or clearing,” Kinard added.

Several of the CDRH’s annual reports were also pulled from the center’s site Wednesday afternoon. CDRH released and posted its 2024 report Jan. 17.

Meanwhile, Dorothy Fink, the HHS’ acting secretary, ordered a pause on Jan. 21 on communications from health agencies, according to the Associated Press.

“We count on the HHS especially to be transparent and a scientific voice so doctors and patients are informed about emerging and existing prevailing health trends,” Public Citizen’s Abrams said.

A page on increasing clinical trial participation for the LGBTQ+ community was removed as of Monday. It was last archived on Jan. 18

[….]

A page for the CDRH’s Health of Women Program was also removed as of Monday. It was last archived on Dec. 24, 2024. The program was started in 2016 to address sex- and gender-specific issues in medical technology design and performance.

Eileen Barrett, a hospitalist and president-elect of the American Medical Women’s Association, said having women and LGBTQ+ people represented in clinical trials “should be apolitical.”

“Nobody wants the patients to get worse care because we aren’t acknowledging the entire context in which they’re experiencing their health and also the way they experience healthcare delivery,” Barrett said.

Webpages were also down on the CDRH’s recent Home as a Health Care Hub initiative, including an announcement for the program and a listening session the agency held last year. The program was launched in April by Michelle Tarver, who was named CDRH director in October. The program is intended to provide resources for devices to be designed with a home environment in mind, starting with a focus on diabetes.

Another removed page referenced a virtual public meeting on real-world evidence slated for Jan. 30.

[….]

Zuckerman said the communications blackout makes a “bad impression,” raising questions about whether the public will be notified about important recalls or product approvals.

“I think there’s so much that needs to improve with transparency, and I see things going backwards,” Device Events’ Kinard added

To read the entire article in MedTech Dive, click here.