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I'm not sure I understand your question. The new drug approval process is already incredibly expensive. If new drugs had to make there way through TWO bumbling, disorganized, inefficient bureaucracies before receiving approval it would make them even more expensive than they are now. I agree that safety trumps efficacy, but I don't know you one could check for both without creating another bureaucracy to do so.

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Let me try again. Why check for efficacy? Why not ONLY check for safety? It would eliminate the most expensive part of the current FDA procedure and make drugs approvals easier and quicker as well as eliminate the FDA deciding trade-offs between safety and efficacy. Half the bureaucracy not twice.

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In the case of the Covid vaccines, it's not clear that they really checked for either safety or efficacy. I guess with an EUA it doesn't seem to matter.

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I suppose if we did that Big Pharma would focus totally on safety and the drugs would be useless, but safe. Somehow efficacy needs to be established.

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