Dr. Marty Makary, a Johns Hopkins surgeon who is poised to become the next commissioner of the Food and Drug Administration, told senators Thursday that he will stick to the science, if confirmed.
In his testimony before the Senate Health, Education, Labor and Pensions Committee, Makary said he wanted to help restore America's trust in the FDA and the products it regulates.
"If we have the cure for pancreatic cancer, but only 40% of the public is going to come in and take it because the rest don't trust us, then that medication is only 40% effective," he said. "So I think we fight bad ideas with more ideas. I don't … believe in censorship of scientific opinions. I think we need a civil discourse."
When pressed on several controversial topics, such as access to the abortion pill and firings at the FDA, he didn't answer directly and said instead he would "do an assessment" after becoming FDA commissioner.
Here are five things that came up during the confirmation hearing.
On abortion pill access
Multiple senators asked Makary whether he would maintain current access to mifepristone, a pill used in medication abortions and miscarriage management up to 10 weeks gestation. Sen. Bill Cassidy, the Louisiana Republican who chairs the HELP committee, asked whether Makary would end telemedicine access to the drug.
The FDA approved mifepristone in 2000 with limitations, but restrictions such as requiring patients to take it in a doctor's office, were lifted during COVID and made permanent during the Biden administration. Medication abortion accounted for 63% of all U.S. abortions in 2023, according to the Guttmacher Institute, a research organization that supports access to abortion.
"I have no preconceived plans on mifepristone policy except to take a solid, hard look at the data and to meet with the professional career scientists who have reviewed the data at the FDA, and to build an expert coalition to review the ongoing data which is required to be collected as a part of the REMS program," Makary said.
REMS stands for "Risk Evaluation and Mitigation Strategy." The FDA adds REMS programs to some drug approvals, and they can limit how drugs are prescribed and distributed.
Makary said he would look at the data before making any decisions. He wouldn't commit either way to limiting or maintaining access to mifepristone.
"Well, I wish you were hedging a little bit less today," said Sen. Maggie Hassan, a Democrat from New Hampshire.
On the FDA vaccine advisory committee
Senators also asked Makary what he would do about the recent cancellation of a vaccine advisory committee meeting that was scheduled to consider next season's flu shot.
FDA advisory committees are made up of experts outside the agency. They publicly deliberate and vote on various questions of interest to the agency. Ultimately the FDA can go along with those recommendations or ignore them.
This committee, called the Vaccines and Related Biological Products Advisory Committee, or VRBPAC, was set to evaluate which strains of flu to include in next year's flu vaccine.
Makary said he had nothing to do with canceling the meeting, because he didn't yet work at the FDA.
"You have my commitment to review what the committees are doing, how they're being used," he told Sen. Cassidy. "As you know, I was critical when that committee was not convened at all during one of the COVID booster guidance decisions by the FDA."
But, he added, there's a "huge difference" between cancelling one of these meetings for the flu shot, in which he says members just "rubber stamp" what international organizations already recommend, and having a transparent meeting over whether "requiring every 12-year-old girl in America to take an eighth COVID booster shot."
He also answered questions about conflicts of interest for the members of the committees.
"We need to review the ethics policy because people see things that appear to be a cozy relationship between industry and the regulators that are supposed to be regulating the products," he said. "Now, I want American companies to thrive. I want life sciences companies to thrive. But we need to call balls and strikes and then keep that independent scientific review process free of any conflicts."
To have the experience needed to serve on these committees, members often have histories working with companies doing the kind of work they are helping to evaluate.
Later Sen. Susan Collins, a Republican from Maine, asked if Makary would reinstate the vaccine panel's meetings. He replied that if he's confirmed, "The VRBPAC committee will be meeting."
He also told Sen. John Hickenlooper, a Democrat from Colorado, that "vaccines save lives." Makary added later, "And I do believe that any child who dies of a vaccine-preventable illness is a tragedy," in a response to a question about the recent measles outbreak and HHS Secretary Kennedy's stance on vaccines.
On FDA firings
Makary said he would take a look at the recent firings at the FDA, which included people working on factory inspections, medical device evaluations and veterinary drug reviews.
"If confirmed as commissioner, you have my commitment that I will do an assessment of the staffing and personnel at the agency," he said. "I have not been involved in any of the decisions regarding any of the personnel changes recently, but if confirmed, you have my commitment that I will do an assessment."
Collins pressed him on whether he would be the one doing the assessment. He replied that he would be.
On drug prices
High prescription drug prices came up a few times during the hearing, which is something Makary said he thinks he can help solve.
He suggested that if more drugs were sold without a prescription, their prices would drop.
"It would force the companies to put a price on the shelf," he said. "And I do believe in price transparency. It will have an effect on the entire marketplace."
He also said he wanted to work with Congress to rein in abuse of the patent system, which has allowed companies making brand name drugs to stave off competition from generics and biosimilars.
On chemicals in food
In his opening remarks, Makary brought up the effect of food on health: "Childhood obesity is not a willpower problem, and the rise of early onset Alzheimer's is not a genetic cause. We should be, and we will be addressing food as it impacts our health."
Later in the hearing, Makary said that if confirmed, he would instruct the FDA to look into chemicals in food that cause inflammation, even though they're currently recognized as safe.
"Half of our nation's children are sick and nobody has really been doing anything meaningful on this front until we have gotten new momentum and enthusiasm from Secretary Kennedy and President Trump to finally address the root causes of these diseases," he said.
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