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A recent New York Times article argues that FDA Commissioner Scott Gottlieb, while still controversial, may be breaking the mold in the Trump administration, balancing industry interests with public needs. Image by the FDA/Flickr. Public domain.

Surprisingly absent from a year’s worth of presidential scandal and intrigue is Scott Gottlieb, Donald Trump’s choice to head the federal Food and Drug Administration.

An article recently published in The New York Times characterizes the physician as being, at first glance, a typical pick for the administration – wealthy, with longstanding links to the industry he’s been appointed to govern. Before becoming a government czar, Gottlieb held investments in 20 companies which relied on the FDA for eventual approval.

“Unprecedented financial entanglements,” claimed Sen. Patty Murray (D-WA) during Gottlieb’s confirmation hearing.

While the physician-cum-department head has been oft-criticized for his financial connections to healthcare, Gottlieb is generally acknowledged as at least being qualified to hold his post – something which can’t be said of every Trump appointee, past and present.

But Gottlieb, writes the Times, has managed to strike an unusual balance from atop the FDA, defending the public while making concessions to the industry.

“He doesn’t want to blow up the agency,” said Mark Schwartz, an attorney who’s worked with the FDA through Republican and Democratic administrations alike.

And Gottlieb’s style of management has won praise from the president, too, with the commander-in-chief once saying, “Scott Gottlieb, as you know, is a star.”

“He’s being thoughtful; he’s being deliberative,” said William Hubbard, retired from the FDA after a 30-year career with posts ranging from consultant to former commissioner. “He seems to be putting aside some of his more extreme rhetoric from when he was outside, and working through the issues with a public-health orientation.”

Even though some officials of the past and present have started to show Gottlieb as having an open mind, others have retained a firmly antagonistic stance. Criticism still focuses on the doctor’s unabashedly pro-industry stance. Among the first and most sweeping reforms enacted by Gottlieb was a loosening on regulations, allowing certain medical devices and medications to hit the market with less testing.

“The bottom line is this: He’s pursuing a pro-industry deregulatory agenda that ultimately is going to put patients at risk,” said Dr. Michael Carome, director of Public Citizen’s health and research arm. “The FDA now views industry as their customers, and they need to keep them happy.”

With Gottlieb, it seems, consensus is hard to come by.

The only safe conclusion to draw is that the FDA’s current chief seems to be performing a delicate balancing act – acting in an ordinary capacity, toeing a line without the craziness of Trump’s other high-powered department heads.

Among the best examples printed by the Times was Gottlieb’s strong moves against the tobacco industry, which were themselves coupled with a handful of light concessions. Gottlieb, for instance, caused cigarette company stocks to divebomb after announcing that the FDA may mandate lower nicotine levels in tobacco – but he also pushed back a deadline on e-cigarette and cigar restrictions by several years, saying smokers needed better substitutes for cigarettes.

“It’s somewhat ironic to me that it takes a Republican administration to think about a new regulation like that, that would have a benefit for the public health,” said tobacco control expert and University of Michigan dean emeritus Kenneth Warner.

Sources

F.D.A. Chief Goes Against the Administration Stereotype

FDA nominee to recuse himself from decisions on more than 20 health-care companies

FDA nominee won’t commit to banning flavored e-cigarettes, cigars

Opponents of FDA Nominee Scott Gottlieb Invoke Opioid Crisis

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