NCPA


Excerpted From: John C. Goodman and Gerald L. Musgrave

Patient Power (Washington, DC: Cato Institute, 1992)
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Experimental Drugs for Terminally Ill Patients

The federal Food and Drug Administration (FDA) has a power that is unique in the health care system, and which in some respects is hard to justify. Although physicians may legally engage in almost any kind of experimental surgery, they cannot administer a drug unless it has first been approved by the FDA. This is a puzzling division of power, considering that on the whole surgery is much more life threatening than drugs. Moreover, since 1976, the FDA has extended its reach, and it now controls all implanted devices, ranging from pacemakers and artificial joints to breast implants. Whereas cosmetic surgeons have virtually unlimited freedom to perform experimental breast surgery, their right to use a conventional breast implant is regulated by the FDA. In addition, Medicare is citing FDA policies in refusing to pay for the latest cancer-fighting drugs.

In recent years, the wisdom of investing the FDA with so much power has been called into question. AIDS patients, unable to get access to experimental drugs, have invaded the FDA’s Washington headquarters in protest. Alzheimer’s disease patients, unable to obtain the drug THA, have filed a class action suit. Breast cancer patients have formed an anti-FDA lobbying group, and even the National Cancer Institute has complained about FDA tardiness in approving new drugs.

Such complaints are not new. In the professional literature in the 1970s, the FDA was accused of responsibility for 10,000 heart-related deaths a year because it kept beta-blockers off the U.S. market long after they had proved successful in Europe. The current policy of denying people on death’s doorstop an opportunity to take risks would seem unwarranted and in need of change.


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