What does the FDA actually look like on the inside — and why does its structure matter for drug approvals, rare disease therapies, and biotech investment?

This week on the Making Medicine Podcast, host John Stanford is joined by Jef Akst, senior editor at BioSpace, to break down the FDA's key divisions, what each one is responsible for, and how they shape the drug development landscape.

Jef walks through the roles of CDER (Center for Drug Evaluation and Research) and CBER (Center for Biologics Evaluation and Research) — what each center oversees, how they differ, and why their review processes matter to biotech companies navigating approval timelines. The episode also explains how FDA advisory committees work, what authority they hold, and how their recommendations influence regulatory outcomes.

The conversation then expands to the broader policy environment shaping biotech today — including CMS marketplace rule changes that affect patient cost exposure, Section 232 pharmaceutical tariff procedures, Most Favored Nation pricing, and the Orphan Cures Act.

The episode closes with data from the INCUBATE Coalition's biotech investment tracker, examining how IRA policy and regulatory uncertainty are influencing capital allocation across the life sciences sector.

Check out the full report from Manatt Health
https://www.incubatecoalition.org/post/one-pager-complete-report-regulatory-instability-at-fda-is-reshaping-biotech-investment

Check out INCUBATE'S biotech investment tracker
https://lifesciencetracker.com/

Join the Conversation ⬇️
Do you think FDA leadership turnover is creating too much uncertainty for biotech companies and investors?
Should the FDA rely more heavily on advisory committees and outside scientific experts during periods of instability?
How should policymakers balance lower healthcare premiums with the risk of higher out-of-pocket costs for patients?
Let us know your thoughts in the comments below 👇

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Time Stamps
00:00 Intro & Disclaimer
00:17 FDA Instability & Biotech Uncertainty
00:39 Meet BioSpace’s Jef Akst
01:51 FDA, HHS & RFK Jr. Influence
04:13 What CDER Does
05:55 Drug Delays & FDA Inconsistency
07:23 What CBER Does
10:33 Office of Therapeutic Products Turnover
13:08 FDA Commissioner’s Role Explained
15:17 Advisory Committees & Expert Panels
18:00 CMS ACA Rule Changes
19:24 Pharma Tariffs & MFN Pricing
21:06 Senator Bill Cassidy’s Primary Loss
22:50 New Biotech Investment Tracker Data
24:41 Rare Disease Investment Trends
25:17 Closing Thoughts

DISCLAIMER: We’re reporting on the headlines, not making medical recommendations. For personal health questions, always consult a doctor.

#FDA #Biotech #HealthcarePolicy #DrugDevelopment #RareDisease #CMS #Pharma #LifeSciences #MFN #MakingMedicine