January 18, 2026
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FDA Chief’s 1‑Month Drug Voucher Plan Spurs Legal and Safety Fears

The article reports that FDA Commissioner Marty Makary has launched the Commissioner's National Priority Voucher program, an unprecedented effort to approve certain drugs in as little as one month if they are deemed to support "U.S. national interests," prompting alarm inside the agency about legality, ethics and patient safety. Seven current or recently departed FDA staff tell AP that reviewers have been instructed to skip normal regulatory steps on at least one highly anticipated anti‑obesity drug, and that scientists had to rush voucher paperwork for Eli Lilly and Novo Nordisk after the White House tied their participation to obesity‑drug price cuts President Trump wanted to announce. At the top levels of FDA there is still confusion over who actually has the legal authority to sign approvals under the voucher scheme, which has never gone through the normal public rulemaking and sits atop a half‑dozen existing, congressionally authorized fast‑track programs that already give the U.S. the world’s fastest reviews. Outside experts like Harvard’s Aaron Kesselheim warn that a one‑to‑two‑month review "does not have scientific precedent" and cannot match the depth of standard six‑ to ten‑month assessments, while Reuters has already documented two voucher drugs being delayed amid safety issues, including a patient death. HHS insists the program maintains "gold standard" science, but former FDA lawyers say its opaque application process and pricing‑linked White House rollouts make it highly vulnerable to politicization, feeding broader concerns that Trump‑era health policy is subordinating independent drug oversight to short‑term political goals.

FDA and Drug Regulation Trump Administration Health Policy

📌 Key Facts

  • FDA Commissioner Marty Makary has created the Commissioner's National Priority Voucher program promising drug approvals in as little as one month for products labeled in the "U.S. national interests."
  • Seven current or recently departed FDA staff say the program is causing confusion and pressure to skip normal regulatory steps, including on a major anti‑obesity pill, and that reviewers had to scramble to process vouchers for Eli Lilly and Novo Nordisk so Trump could pair them with obesity‑drug price‑cut announcements.
  • Reuters has reported that review of at least two drugs in the voucher program has already been delayed over safety concerns, including a patient death, while legal experts note the scheme has not gone through normal federal rulemaking and appears unusually open to political influence.

📊 Relevant Data

In 2025, obesity rates among US adults were 49.9% for Black adults, 45.6% for Latino adults, 36.9% for White adults, and 16.1% for Asian adults, with Black and Latino adults having the highest prevalence.

State of Obesity Report 2025: Better Policies for a Healthier America — Trust for America's Health

Evidence from twin, family, and adoption studies supports that 40-70% of the variation in obesity is due to heritable genetic factors, which may contribute to racial disparities in obesity prevalence.

Epigenome-wide association study meta-analysis of BMI and body fat percentage in children and adolescents — medRxiv

Drugs approved under the FDA's Breakthrough Therapy Designation experienced an average of 1722 more serious adverse events per drug compared to those without the designation, based on analysis of approvals from 2012 to 2023.

Study: Expedited breakthrough drug approvals linked to higher safety risks — Gies College of Business, University of Illinois

The economic impact of obesity on major US industries was estimated at over $347 billion in 2023, including costs from productivity losses and healthcare expenditures.

New study finds obesity costs US industry $347bn a year — Pharmaceutical Technology

📰 Source Timeline (1)

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January 18, 2026
6:04 PM
FDA's new expedited drug program raises legal questions and concerns
PBS News by Matthew Perrone, Associated Press