ATR suggests 7 reforms for improving FDA performance.

The Americans for Tax Reform (ATR) informed the Reagan-UDall Foundation in a letter that the US FDA has "seriously and significantly failed" to fulfill its congressional mandate to protect public health.

After months of criticism for its handling of the electronic cigarette review, the Reagan-Udall Foundation is now reviewing the policies and procedures of the FDA's Center for Tobacco Products (CTP). As part of its evaluation, the foundation is providing stakeholders with an opportunity to share their opinions.

In its commentary, ATR suggests seven reforms to enhance the performance of the institution.

The FDA is being urged to incorporate input from interdisciplinary experts, such as those in the fields of psychology and behavioral economics, to increase public awareness and participation in the decision-making process. As promised, the FDA must provide a streamlined pathway for pre-market tobacco applications (PMTA) that is simple and accessible.

The FDA's pre-market application process should prioritize product safety and individual risk rather than behavior and population assessments that can be better collected by a single post-market surveillance team. The FDA should regularly and proactively communicate with all applicants rather than issuing marketing rejections after a year of silence. The agency should consider implementing product standards to streamline the process and look to countries like the UK as a model for effective regulatory systems. The FDA must urgently take action to combat significant public misinformation recognized to exist in the community and serve as an obstacle to smoking cessation. It must reform its approach to addressing adolescent risky behavior and acknowledge that reducing harm can benefit young people while properly assessing the consequences of reducing e-cigarette use among adults and adolescents. Tim Andrews, ATR's director of consumer issues, wrote that the Reagan-Udall Foundation review can help the agency improve its pre-market tobacco review process.

The current pre-market application process for tobacco products is burdening applicants with impossible administrative requirements," he said. "The FDA has failed to notify applicants when the process and requirements change, and reportedly applied different standards to certain applicants. This failure is systemic and our opinion recognizes that these issues cannot be solved by simply increasing funding, especially not by charging user fees to small e-cigarette manufacturers.

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