I will admit that he surprised me in that he wasn't nearly as bad as I'd feared he'd be when Trump announced his appointment. On cracking sham on quack stem cell clinics, he's been pretty good. 1/https://twitter.com/carlyweeks/status/1114188419679363073 …
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What I fear is that Trump might nominate one of the libertarian kooks he considered before choosing Gottlieb. I wrote about just hie scary they were during the presidential transition. 2/
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I feared that Peter Thiel would be picking the new FDA Commissioner. Let's take a trip down memory lane. 3/https://sciencebasedmedicine.org/donald-trump-vs-the-fda-be-afraid-be-very-afraid-of-the-loosening-of-drug-approval-standards/ …
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One candidate, Jim O'Neill, was a libertarian into anti-aging woo. He believes in going back to the pre-Kefauver days of the FDA, when all a company had to do was to prove safety, with efficacy to be proven later. 4/
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O'Neil also makes bad analogies, noting how software development is completely unregulated, while biotech is heavily regulated, which to him is why the pace of drug development has slowed down and biotech is very expensive compared to software.

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Seriously. O'Neil made that analogy. He truly doesn't understand the differences between software development and drug development! Why should he? He's a venture capitalist, not a biomedical scientist. 6/
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Then there was Balaji Srinivasan. Hilariously, when his name came up as a candidate for FDA Commissioner, he deleted his Twitter feed because it contained such hostility directed at the FDA. The Internet being the Internet, though, his words soon came back to haunt him. 7/
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Srinivasan, of course, was not a scientist either. He ran a Bitcoin startup (because of course he did). 8/
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His main expertise is digital payments and computational biology, and his expertise in health regulation stems from a start-up company he co-founded, Counsyl Inc., which offers DNA screening, especially for people considering having children. 9/
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Srinivasan's "big idea" was to replace many clinical trials with online reviews for drugs; i.e., a "Yelp for drugs" or using the Uber model for drugs. 10/
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So...now that @SGottliebFDA is gone, my fear is that Trump will go back to Jim O'Neill, Balaji Srinivasan, or some other Peter Thiel-picked libertarian nutjob who thinks the FDA is killing people and that the free market can determine which drugs are safe and effective. 11/11
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Replying to @gorskon
Elizabeth Holmes seems well qualified in this field. Jesus!
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