FDA’s influence can be summed up in a simple statistic: About 20 cents of every dollar that Americans spend is on a product — whether food, drug or tobacco — that’s regulated by the agency. But that enormous responsibility has also exposed the FDA to a broad array of critics, including President Donald Trump, who last year bashed the agency’s reviews as “slow and burdensome.”

Trump’s pick to reform the agency? Commissioner Scott Gottlieb, who’s steered FDA since last May to the praise of conservatives — and, surprisingly in this political moment, some progressives who think he’s successfully balanced political pressures with public health priorities.

Gottlieb joined POLITICO’s Dan Diamond to reflect on the agency’s 2017 achievements and why he joined the Trump administration (Starts at the 1:30 mark), the FDA’s nutrition policy and its role in keeping food safe (9:30), whether FDA is approving too many drugs (13:15), his to-do list for 2018 and looming policy priorities (19:00), the ongoing crisis in Puerto Rico and the effect on medical product development (22:10), how his role as a sometime-critic of FDA has squared with running the agency (25:45), FDA’s tobacco strategy (27:15), and a quick lightning round on Gottlieb’s infamous skinny jeans and other not-so-pressing questions (28:15).

Then after the break, POLITICO senior food and agriculture reporter Helena Bottemiller Evich and pharma reporter Sarah Karlin-Smith analyze Gottlieb’s comments and discuss the looming challenges for the agency. (Starts at the 30:00 mark.)

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Stories referenced on the podcast:

Matthew Herper’s review of Gottlieb’s top articles for Forbes: https://www.forbes.com/sites/matthewherper/2017/03/10/the-best-stories-scott-gottlieb-the-next-fda-commissioner-wrote-for-forbes/#5e1234d1c523

Gottlieb’s January 2016 article on the need for FDA to change its regulation of novel technologies: https://www.forbes.com/sites/scottgottlieb/2016/01/12/fda-needs-to-change-how-it-regulates-novel-technologies/#45a8b372191e

Sarah’s look at what’s ahead for pharma in 2018: https://www.politico.com/newsletters/prescription-pulse/2018/01/03/pharma-weathers-storm-over-drug-prices-may-shift-tactics-062669

Helena’s article, “The Great Nutrient Collapse,” one of POLITICO’s most-read stories in 2017: https://www.politico.com/agenda/story/2017/09/13/food-nutrients-carbon-dioxide-000511

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