The FDA and Big Pharma: Watchdog or Lapdog?

Yesterday I wrote about the latest Big Pharma scandal to crawl out from under a rock. It shows, once again, the extent to which many doctors—in this case, psychiatrists—are compromised by their relationships with the drug companies, and the damage these conflicts of interest can do to patients. The same is true of the Food and Drug Administration—and in a way, that’s even worse, since the FDA is supposed to be our watchdog, and has instead too often become Big Pharma’s lapdog.

In an op-ed in yesterday’s Boston Globe, Marcia Angell offers a seven-point agenda to “restore the FDA to its purpose, which is to protect the public from unsafe food, drugs, and devices, not to accommodate the industries it regulates.” She sees the appointment of industry critic Joshua Sharfstein as deputy FDA commissioner as a promising sign—but only a beginning.

Angell, who teaches social medicine at Harvard Medical School and wrote a sharp book on how Big Pharma operates, suggests a series of changes to the system under which drugs are developed, approved, and marketed. Personally, I’d like to see something slightly more dramatic—maybe along the lines of replacing the lab animals used to test new drugs with pharmaceutical company executives. But as a realistic starting place for public policymaking in this area, Angell’s agenda is as sound as anything I’ve seen.