The point of course – is what does public support for drug research have to do with the FDA’s efficacy authority on drugs? In fact, given that the government is supposed to study how it offers its grant money, isn’t that already a layer of supervision that would not otherwise be there?

And marketing machines? Great. I WANT firms to market to me all of the ways they can make me healthy and comfortable.. I am sure Queen Anne of England would have felt the same way. Google her for a fun little story.

“The FDA, Cartelization and the Crushing of Small Business

As with much regulation, it is entirely conceivable that big drug companies LIKE being regulated by the FDA. See the history of the US tobacco settlement for a really vivid illustration of this”

inchoate indeed

Go round up evidence of a recent miracle pill not conceived principally by work financed with public funds at a major university, rather than in the bowels of, say Pfizer, Merck, or GSK. We won’t hold our breath.

Wake the hell up: Rxcos are marketing machines that are the principal sources of, the primary cheerleaders for, the regulatory burden you & the author lament.

It will take me more time than I have now to read the above carefully, but all is well-stated, and I agree with your analysis, which is irrefutable.

The FDA is a Dewey-inspired organization originally sold to our grandparents to protect them from snake-oil salesmen, and it has morphed into being the gatekeeper to keep us from the evil pharmaceutical companies who might charge our insurance companies a penny more a pill that is not statistically any more efficacious than another pill, according to double-blind studies. Their mission is not to relieve us of suffering, but to make sure no one selling pills makes a dime extra.

Thus any promising chemical, whether or not it may offer help to a particular patient, is denied approval because it is not effective for everybody. Moreover, any pill that does get approved has to go through trials that cost a half a billion dollars, and once the pill gets approved, there are armies of plaintiff and defense lawyers poised to litigate if the approved drug has any unforseen side-effects.

Despite these obstacles, our drug companies create miracles, and they are the envy of the world. They also are the object of envy by our elected officials, who, after they have participated as if they were stockholders by taking their slice of the pie, perversely want to dictate prices.

I’m all for requiring that drugs be safe, but that is a small fraction of the regulatory cost. I am sick of whether compound XYZ might not fit into Blue Cross’s formulary, and I wish we were free to choose what drugs we buy, without the FDA approval for efficacy.

Aren’t we smart enough to evaluate whether the snake oil is extra virgin, and know it’s 90 proof?