Surveying how the FDA functions helps to confirm that point. The cost in time and money to commercialize a new pharmaceutical is beyond staggering. According to one recent estimate, taking a drug from discovery through FDA approval and getting it into pharmacies carries a price tag north of $1 billion and can take 10 to 15 years. Underscoring how difficult the process is to complete, the FDA approved just 355 therapeutic drugs and biologic agents between 2009 and 2018.

Indeed, only 1 in 1000 compounds that enter laboratory testing actually make it to the FDA review process. The agency’s regulatory framework is far from perfect—with some experts arguing it’s actually far too expensive and cumbersome—and often limits patient access to medicines that could save lives. Nevertheless, these flaws are hardly evidence that FDA rubber-stamps new drug applications or does the bidding of industry.

While there are undeniable cases of Big Pharma malfeasance in drug development and marketing (which should be punished), far less attention is paid to the rampant misdeeds of wellness gurus who market fad diet books, untested supplements and any number of questionable lifestyle products. It’s these activists with enormous financial conflicts of interest who so often drive the narrative of a pharma-dominated FDA, and who have increasing influence over federal health policy.

This prompts an important question: is industry influence over federal regulations universally dangerous, or is it OK when “health coaches” and trial lawyers like Robert F. Kennedy, Jr. shape policy? Join Dr. Liza Dunn and Cam English on this episode of Facts and Fallacies as they tackle that messy issue.

Dr. Liza Dunn is a medical toxicologist and the medical affairs lead at Bayer Crop Science. Follow her on X @DrLizaMD

Cameron J. English is the director of bio-sciences at the American Council on Science and Health. Visit his website and follow him on X @camjenglish