Makary Out at FDA. Independent Doctors Urge the Next Commissioner to Confront America’s Prescription Drug Crisis — and End Big Pharma’s Capture of the Agency

Key Takeaways

• 69% of U.S. adults take a prescription daily
• Prescription spending reached $806 billion in 2024, up 10%
• 9 in 10 seniors take at least one prescription drug
• IMA urges White House to appoint reform‑focused FDA commissioner

Pulse Analysis

America’s prescription drug consumption has reached unprecedented levels, with 69% of adults taking at least one medication each day and seniors nearing a 90% usage rate. In 2024, national spending on prescriptions surged to $806 billion, a 10% jump from the prior year, while retail pharmacies filled nearly 5 billion prescriptions in 2025—roughly 15 per person. These figures underscore a systemic reliance on pharmaceuticals that strains both individual health and the broader healthcare budget, prompting clinicians to label the trend a public‑health crisis.

The Independent Medical Alliance argues that the FDA’s regulatory posture has become overly aligned with Big Pharma, effectively acting as a rubber stamp for new drug approvals. Critics point to decades of revolving‑door relationships, advisory committee appointments, and expedited review pathways that favor industry timelines over rigorous safety assessments. This perceived capture erodes public trust and may contribute to the over‑prescribing culture, as clinicians feel pressured to adopt newly approved therapies without sufficient long‑term data. The alliance’s white paper highlights that many patients are now managing multiple prescriptions simultaneously, raising concerns about drug interactions and chronic dependency.

Political momentum is building as the IMA calls on the White House to select a commissioner willing to confront pharmaceutical influence and prioritize patient outcomes. Potential reforms include stricter conflict‑of‑interest rules, enhanced post‑market surveillance, and a renewed emphasis on non‑pharmacologic treatments. If implemented, such changes could recalibrate the drug development pipeline, encourage more responsible prescribing, and ultimately reduce the $806 billion annual spend. Stakeholders—from insurers to biotech firms—will be watching closely, as a shift in FDA leadership could reshape market dynamics and set new standards for drug safety in the United States.