The Make America Healthy Again movement has proven to be more than just a campaign talking point for President Donald Trump as the U.S. Food and Drug Administration (FDA) implements sweeping changes right out of the gate to address agency capture.
In sweeping and long-overdue reform, the FDA announced Thursday that it will remove pharmaceutical industry representatives from its powerful advisory committees—a historic step toward restoring scientific integrity and eliminating conflicts of interest.
The decision, revealed by FDA Commissioner Dr. Marty Makary in an interview with Megyn Kelly, marks the most aggressive move in decades to eliminate Big Pharma’s conflicts of interest at the heart of America’s drug regulatory process.
“The scientific evaluation needs to be independent,” Dr. Makary said. “I was shocked when I learned that pharma companies sit on FDA advisory committees as members of those committees. So we are going to be replacing them whenever statutorily possible with patients and family caregivers.”
The announcement represents a paradigm shift in how the FDA engages with industry, putting patients and caregivers at the center of regulatory decision-making where once there were corporate executives and company-funded scientists.
Makary said he wants American pharmaceutical companies to do well, like any U.S business, but the scientific evaluation needs to be independent.
“The pharma and device members on those advisory committees will say that they are ‘non-voting members,’ but there is a sort of a close club of individuals that has a running dialogue… [and] we need the scientific evaluation and the voting to be totally independent,” he added.
Advisory committees serve as key gatekeepers to FDA decisions, issuing recommendations that often determine whether new drugs and vaccines are approved for public use. Historically, these panels have included voting members with financial ties to the very companies whose products they are charged with evaluating. Critics have long argued this is the regulatory equivalent of the fox guarding the henhouse. Now, under Makary’s leadership, that dynamic is being forcefully upended.
Rather than granting industry insiders a seat at the table, the FDA will allow pharmaceutical companies to attend advisory committee meetings alongside the general public—permitted to observe, submit questions, and offer comments, but stripped of any formal influence.
According to Makary, “We are going to be inviting pharma companies to send representatives to the advisory committees, but they can sit with the rest of the public and watch and pose questions as the rest of the American public can.”
When people ask Makary if he’s anti- or pro- pharma, he says that he’s pro-pharma but the evaluation process has to be independent. “We cannot have any more indications for chronic pain written for a drug based on a 14-day study where the regulator then goes immediately works for the company,” he said.
The big pharma revolving door at the FDA is no secret. Senior leaders go back and forth between government agencies and pharmaceutical companies, but that culture needs to change and Americans should not “tolerate” that behavior.
“We cannot have people who leave as regulators go to the industry, and we’ve thought about an ethics pledge. We’ve thought about all kinds of things,” he said. “It’s non-binding because we live in a free country… but what we can do is create a culture here where people want to stay. We can ensure that people who leave don’t have undue influence.”
The “influence” piece is something Makary says he has already personally experienced before he went through the confirmation process to become commissioner.
“When I got this nomination for the job, I cannot tell you how many lobbyists, former members of congress—‘the swamp’ reached out to me,” Makary recalled. “I mean, I was in the operating room and the next day I discovered what the swamp was.”
He said the overtures came in the form of things like “we want to help you with your confirmation,” or “we want to write a letter on behalf of our company to the senators on your committee,” or “we know these senators, we’re going to talk to them if it’s okay with you.”
Dr. Makary turned them all down. “You know what I said?” Makary asked. “Don’t talk to the senators. I don’t want your letters. They’re not for free. Those are obligations that then you feel indebted to return once you’re in office, and I’d rather not get confirmed into this job and have those obligations.”
The move is part of a broader campaign by Makary to reclaim the agency’s independence, which many believe has been eroded over the past two decades by political pressure, revolving doors, and industry capture.
Indeed, public confidence in the FDA has declined significantly in recent years, largely due to concerns about its close ties with pharmaceutical giants and questions surrounding the approval of controversial products. Scandals related to the opioid crisis, the expedited approval of expensive drugs with questionable efficacy, and the lack of transparency during the COVID-19 pandemic showed the FDA has not been serving the public interest.
Now, with the removal of industry members from advisory committees, the FDA is signaling a new era—one defined by transparency, independence, and a commitment to science over special interests.
The implications of this change are enormous. In practical terms, it means that no longer will executives from Pfizer, Moderna, Johnson & Johnson, or any other pharmaceutical firm vote on whether their own or a competitor’s product should be approved. No longer will regulatory decisions be shaped by individuals with vested financial interests in the outcomes. And no longer will the American public be forced to wonder whether drug safety decisions are made by scientists or shareholders.
The move is not merely symbolic. It strikes at the very core of how policy is shaped inside the agency. Critics of the previous system argue that industry influence on advisory committees enabled companies to shape outcomes, steer discussions, and suppress dissenting voices, particularly when billions of dollars were at stake. By contrast, giving patients and caregivers a voice on these panels brings lived experience to the table and may reshape how safety and efficacy are evaluated.
While some will undoubtedly criticize the FDA’s decision as hostile to industry or unnecessarily disruptive, supporters argue that it is precisely what is needed to rebuild credibility. Transparency and accountability are not optional in an agency tasked with safeguarding the nation’s health—they are prerequisites. And without independence from the industry it regulates, the FDA cannot fulfill its mission.
The FDA’s decision to cut formal industry ties to its advisory committees is not just a policy change—it is a bold declaration that the days of regulatory capture are over.
