On Friday, President Donald Trump nominated Scott Gottlieb as commissioner of the FDA.
The second week of March marks what must be at least the third or fourth controversial appointment by the commander-in-chief. Up until now, Trump has stacked the cabinet with billionaires and named industrial captains to head major federal departments. Andrew Puzder infamously withdrew from a suggested posting as labor secretary after news broke that he opposed the existence of the minimum wage and hired an illegal immigrant housemaid, while Betsy DeVos, education secretary, wants to use public schools to create “God’s kingdom.”
Gottlieb, at least on paper, seems a step above the other under-qualified and out-of-nowhere candidates and Cabinet members. He’s a licensed physician as well as a conservative health policy analyst who served as the former deputy commissioner of the Food and Drug Administration under George W. bush.
The Vox notes that Gottlieb was an oddly well-suited pick. Other considerations for commissioner included Jim O’Neill and Balaji Srinivasan, both Silicon Valley bigshots with absolutely no background in either medicine or medical regulation.
However, Scott Gottlieb is not without his critics.
Much like EPA chief Scott Pruitt, Gottlieb has strong and well-documented ties to the companies and manufacturers he’s due to be regulating.
The proposed commissioner and president both share a desire to cut the cost of prescription and generic medications in the United States. Gottlieb’s plan to accomplish that involves removing regulations and rules designed to keep Americans safe from dangerous drugs and pharmaceutical charlatans.
Advocates of deregulating the FDA claim that the agency’s evidentiary standards are too high. When new manufacturers try to bring a new product into the market, they’re required to shows years’ worth of scientifically tested trials demonstrating both that their product is effective and safe for human consumption. Gottlieb’s likely moves would include lowering the bar for evidence, decreasing scrutiny of proposed medications, and speeding up the process of allowing new medications onto the open market.
DollarsForDocs, a transparency project run by ProPublica, gave an inkling of what motivations might underpin Gottlieb’s loosening of the law: between 2013 and 2015, the physician received almost half a million dollars from 20 different pharmaceutical companies. He sits on the advisory boards of several drug manufacturers and is being eyed with skepticism by some pro-consumer groups.
“Gottlieb is entangled in an unprecedented web of Big Pharma ties,” said Dr. Michael Carome, the director of Public Citizen’s Health Research Group. “He has spent most of his career dedicated to promoting the financial interests of the pharmaceutical industry, and the U.S. Senate must reject him.”
No matter how reserved some healthcare providers might be about Gottlieb’s nomination, the fact remains that he still is experienced professional with the credentials necessary to head the FDA. He might possibly be mildly corrupt or too fiscally conservative to put patients before pharmaceutical profits, but the experience he brings to the agency doesn’t make him an ignorant outsider or fundamentally opposed to the FDA’s mission – Betsy DeVos or Scott Pruitt he is not.
Of Gottlieb, Gregg Gonsalves of Yale had to say:
“It could have been worse.
“We could have had a saber-tootthed tiger guarding the henhouse like Jim O’Neill, and instead we [may get] a garden-variety fox at the helm.”