U.S. Food and Drug Administration (FDA) Commissioner Martin Makary waits for the start of a Senate Appropriations Committee hearing. -- health coverage from STAT
FDA Commissioner Marty MakaryAnna Moneymaker/Getty Images

Matthew Herper covers medical innovation — both its promise and its perils.

Marty Makary, the commissioner of the Food and Drug Administration, has marked his first 100 days in charge of the agency that regulates a quarter of the U.S. economy with a miniature media tour and a series of bold-sounding announcements.

One of those announcements might result in big positive change — if Makary and the FDA can follow through. But others have the same issues many of the commissioner’s announcements have had so far: They threaten to ignore the way the FDA has worked historically, risking the best of an agency that mostly has functioned well for the sake of an uncertain payoff.

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First, the really great idea: making public complete response letters (CRLs), the rejection notices that companies receive from the agency when their medicines are not approved.

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