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Bruce M. Psaty, MD, PhD; R. Alta Charo, JD

JAMA. 2007;297:1917-1920.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The withdrawal of rofecoxib in September 2004 and the reports of health risks associated with several other drugs¹ have raised questions about the integrity of the US drug safety system. In response, and at the request of the Center for Drug Evaluation and Research of the Food and Drug Administration (FDA), the Institute of Medicine (IOM) issued a comprehensive review and set of recommendations for reforms.² The FDA has taken the unusual step of providing a detailed, public response.³ The FDA's new initiatives and its responsiveness to the IOM report represent incremental progress that offers insights into FDA's culture and perhaps glimpses at the future of drug safety.

Setting

The FDA is an underfunded agency charged with regulating products that collectively constitute nearly 25% of the US gross domestic product.⁴ A century ago, the agency started as a bureau with authority to . . . [Full Text of this Article]

Author Affiliations: Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, and Center for Health Studies, Group Health, Seattle (Dr Psaty); and University of Wisconsin Law and Medical Schools, Madison (Ms Charo).

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