Cash Rewards to Speed Drug Reviews

The FDA plans to give money to reviewers who finish ahead of time. Commissioner Makary explained the idea in a staff meeting last week. He called it a pilot program and said the first bonuses could start in August. The goal is to reward “weighted time savings” while keeping quality high. One slide said speed matters but not at the cost of safety. There are questions about how to split the money among big teams. Employees who do not review drugs, like inspectors, will not get a bonus. Some worry that faster reviews might lead to rushed safety checks. The agency has long used drug company fees to hire more scientists and cut review times. About 70 % of the FDA’s drug budget comes from these fees.The extra staff has cut review times by more than half compared to past decades. However, the agency is losing workers. Since last year, about 20 % of drug and biologics staff have left the FDA. Some reviewers are also interviewing with pharmaceutical companies. Makary announced other speed‑up measures, such as one‑month reviews for drugs that help national interests. He also said the agency may allow trials with fewer patients in some cases. Meanwhile, the FDA’s chief scientist has sometimes overruled staff decisions. He recently asked Moderna to run another study for an mRNA flu vaccine before approving it. Critics say the FDA is too close to the drug industry. Health Secretary Kennedy Jr. has called FDA staff “sock puppets” of industry.