“Dozens
of former and current FDA officials, outside scientists and advocates for patients and agency’s efforts to monitor the
ill-effects of drugs on the market are a shadow of what they should be because the
White House and Congress forced a shotgun marriage between the agency and industry years ago [1992] for the rich dowry that
industry offered [campaign contributions].
Under the 1992 agreement the industry pledged to give the agency millions—this year,
$200 million—but only if the agency spent a specified level of money on approvals of new drugs. Since then, as congressional support sank, the agency has cut everything else but new drug reviews. In the past 11 years, spending on reviews has increased from about half to more than
four-fifths of the agency drug center’s budget. Among the priorities that
took the worst hit was ensuring the safety of the drugs that patients are already taking. . . . The FDA cannot require drug
makers to undertake new safety tests once a drug is approved, so tracking the safety of drugs already on the market is the
agency’s responsibility. . . . Indeed, the agency now relies almost entirely on the willingness of drug makers to report
problems that crop up after a drug has been approved to ensure the safety of the nation’s drug supply. {This means that unless they start receiving letters from doctors about repeated side affects, the drug
company won’t know of the problem. It is easy for a doctor to recognize
in patients taking one of the Statins dissolving muscles as being drug induced, but not heart attacks. Even if they occur at twice the normal rate, his sample of coronary events would likely be too small to
notice; moreover he would probably attribute an increase to a random cluster, rather than the Statins.}
[T]his dependency has gradually worn away at the agency’s
willingness to confront drug makers, making it timid and leaving patients vulnerable.
“This is not just about dollars,” said Dr. Jerry Avron, a professor at Harvard Medical School and the author of Powerful Medicines, “it
is a cultural issue in which the agency feels it can’t pressure drug makers.”