The FDA is far too cozy with the drug companies, critics assert, and I tend to agree. It is only going to get worse under an emboldened second Bush administration, since the Republican strategy for American prosperity goes no further than removing regulatory barriers to untrammelled corporate profitability.

The problem is not that Vioxx, or any other drug, has risks — physicians customarily balance risks and benefits in collaborating with their patients on prescribing decisions — but that the process withholds data about the risks from both practitioners and the public. The recent furor over childhood antidepressant use and suicide is the same. One solution would be to separate the FDA’s drug approval machinery from its post-approval drug safety monitoring role, but the fist-in-glove relationship with the industry would likely contaminate the latter’s functioning as well. A better way to address the problem would be to develop a trustworthy independent review board on drug safety issues, beyond the reach of industry gladhanding, sort of like the Underwriters’ Laboratory for household appliances.