New FDA Foundation: The Fox In The Chicken Coop?
1 CommentBy Ed Silverman // October 15th, 2007 // 9:17 am
In the scramble to approve the FDA reform legislation and increase user fees, one item was largely overlooked - the creation of a new drug research center. But there’s an interesting wrinkle - it will be financed by the same drugmakers the agency regulates. The goal of the Reagan-Udall Foundation, which was signed into law late last month, is to streamline and improve the development of drugs and medical devices, the Associated Press writes.
However, this comes at a time when the FDA’s reputation is in the toilet thanks to the perception that it’s soft on safety and too cozy with pharma. For this reason, consumer advocates say the loosely defined partnership increases the agency’s vulnerability to industry clout, the AP notes, despite promise of groundbreaking success. And it’s an ambitious undertaking that puts regulators and companies in a relationship unlike that of any other industry, the wire adds.
Congress required fast-track creation of the foundation. The FDA filed a public notice Oct. 3 that it was accepting board nominations and will name board members Oct. 27. Drug industry executives likely will hold four seats on the center’s 14-member board. The rest will be academics, consumer advocates and physicians, with no voting seats for FDA commissioners or staff.
In an e-mail to the AP, Ted Kennedy, who co-sponsored the bill, wrote that “effective safeguards to ensure that the foundation is independent of both the FDA and its donors, whether those donors are from industry or are charitable organizations.” But critics worry the board’s makeup could allow drugs to be developed more cheaply, improving pharmaceutical industry profits, but not necessarily result in safer and less expensive drugs for consumers.
“Given FDA’s track record in the past, I’m not confident in their ability to create something that is free of influence from industry,” Francesca Grifo, a director at the Union of Concerned Scientists, tells the AP. “Time and again we’ve seen that people within FDA behave as if industry is their primary client.”
However, the law creating the center leaves crucial decisions to the appointed board - from where the center will be located to how funds will be collected from companies and distributed for research, the AP writes. And there are many unanswered ethical questions, such as who will own patents obtained from the foundation’s research and how any potential profits would be shared or distributed.
One crucial issue, though, seems to have been decided, according to FDA Deputy Commissioner Janet Woodcock: “The FDA intends to put forward a variety of research projects that we think are important, but as with any foundation, the donors will have the primary say over how the funds are used.”
Industry execs say it’s premature to commentl, but they do say, as do FDA officials, that they hope the foundation reverses an imbalance between how much industry spends on drug research and the number of drugs making it to market. Drug R&D spending hit $43 billion in 2006, a 150 percent increase the past decade compared with a 2.5 percent rise in the number of new FDA drug applications during that period, the wire points out.
The problem is time and money. Companies on average spend almost 15 years and $1 billion to get a new drug to market, according to the Pharmaceutical Research and Manufacturers of America. The drug development process can involve tracking up to 15,000 patients taking a drug for as long as five years.
At Reagan-Udall, FDA scientists, with private-sector funding, are hoping to do world-class research not being done elsewhere, while giving drugmakers a role in developing more effective drug approval methods and standards. It’s part of the FDA’s Critical Path Initiative, unveiled in 2004, which calls for the agency to work with industry and academia to speed the “critical path” a drug travels from discovery to market.
But critics question the potential trade-offs. “FDA’s primary role is regulating drugs and protecting the public health,” says David Ross, a former FDA safety reviewer at the Department of Veterans Affairs. “If you start blurring that line between regulation and collaboration, you have real problems.”
For example, Ross, who left the FDA last year over a drug safety dispute, is concerned, as are others, that the FDA might be persuaded to quickly adopt a controversial drug-testing process that uses biological indicators, such as blood pressure and cholesterol levels, to determine a drug’s safety.
Drugmakers have taken the unusual step of sharing research data on these indicators, called biomarkers, to see if the size and duration of patient drug trails can be reduced. Some critics call their use a high-risk gamble. “Biomarkers are a bit like dynamite in that they can be extremely useful but they can cause a lot of damage,” says Ross.
He cites a biomarker that suggested irregular heart rhythms were a key predictor of fatal heart attacks. Using the assumption, doctors prescribed heart-regulating drugs to millions of patients in the 1980s, but abruptly halted the practice in 1989 when a long-term study revealed patients were actually more than twice as likely to die of sudden heart failure.
FDA officials counter that HIV biomarkers have turned out be a reliable predictor of survival for patients susceptible to AIDS, a disease that can fatally damage the body’s ability to fight off serious illness. Rachel Behrman, who heads FDA’s Office of Critical Path Programs, says it’s too early to know whether biomarker research would be an initial project. She wants to focus on the opportunities the center will offer.
“This has to do with being smarter,” Behrman says. “That’s what this initiative is about.”
Peter Pitts
Hi Ed –
Please see my comment on this at http://www.drugwonks.com
Cheers.