The FDA Is Recruiting New Advisers Without Publishing the Rule for Who's Too Conflicted to Sit

On September 30 the Food and Drug Administration published two notices in the Federal Register and did something it rarely bothers to do for a personnel call: it attached a press release. The agency, acting commissioner Kyle Diamantas said, was launching a nationwide effort to bring “leading scientific minds” and consumer voices onto the committees that counsel it on cancer drugs, heart medicines, neurology, genetics and medical devices. What the warm language left out is the one rule that would let an outsider judge any of those minds: the standard for deciding which adviser’s financial interest is disqualifying. Congress ordered the FDA to write it in 2012. The agency never has. Self-nominations are welcome, with consumer representatives given until November 15 to be considered for the near-term seats and scientists until November 30, terms running up to four years.

It reads like a civics poster. It is also an invitation into a house the agency spent the past year emptying out. Committee activity collapsed under Diamantas’s predecessor, Marty Makary, with the FDA holding just nine advisory meetings so far in 2026, a fraction of the historical cadence, after it replaced the sitting members of its vaccines panel and ran five ad-hoc “expert panels” on testosterone therapy, menopausal hormone therapy and antidepressants in pregnancy entirely outside the standing system. The seats Diamantas now wants filled are empty in part because the agency decided to stop using them. These panels’ votes are only advisory, but they still shape which drugs reach the market and which safety signals get acted on.

Some of that clearing was overdue. In April 2025 Makary barred employees of FDA-regulated companies from the committees, a blunt swing at the most obvious form of capture, the drug-company scientist voting on the drug company’s product. The panels had carried that kind of passenger for years, and draining them was defensible. The question the September notices never answer is what the agency has been seating in their place.

The record offers one answer, and it is not reassuring. On June 29 the FDA seated 8 new members on its Pharmacy Compounding Advisory Committee, the panel that helps decide which compounded drugs reach patients. 7 of the 8 had financial ties to businesses that sell or administer the exact class of product then on the agenda: synthetic peptides. One charges $500 for consultations that include advice on where to safely source each peptide. Another is chief medical officer of a chain of men’s clinics that sell testosterone and peptide injections. A third, a sitting Tennessee state senator, works as a pharmacist in a family business that sells compounded drugs. Weeks later the reshaped panel voted to loosen restrictions on four peptides, over the warnings of the FDA’s own scientists. The pharma employee was shown the door. The peptide seller was handed a vote.

Which raises the one question that should accompany any recruitment drive and appears nowhere in these notices: who gets disqualified, and who decides. In March 2026 the Government Accountability Office reported that the FDA still has not finalized the conflict-of-interest guidance Congress ordered it to write in 2012, under the Food and Drug Administration Safety and Innovation Act. The agency posted guidance on how it made those determinations until 2019, then withdrew it, promised a replacement to reflect the 2012 law, and as of this year had produced only a draft. It does not disclose how it decides whether a member’s financial interest is disqualifying, or whether a conflicted member may vote anyway. HHS generally concurred with the GAO’s three recommendations and set no date for acting on any of them.

So the notices spelled out the deadlines, the four-year terms, the fields in play. On the single question that separates an independent adviser from a paid one, they said nothing. “Radical transparency,” the governing phrase of this HHS under Robert F. Kennedy Jr., turns out to carry a paperwork debt thirteen years deep, run up under the old management and inherited, unpaid, by the new.

The notices make much of the consumer voice, a seat reserved for someone from a community or patient organization rather than a laboratory. Good idea on its face. It is also the seat least equipped to police the others, because a consumer representative, like everyone outside the building, cannot see the standard by which the scientific members were cleared. You cannot audit a conflict you are not permitted to measure.

Opinion on the drive splits where you would expect. Steven Grossman, who tracks the agency closely, read the unusual press release as a sign the FDA means to revive a working committee system and expected a strong response from scientists and consumer groups. Harvard’s Joseph Daval and Aaron Kesselheim were colder, warning in the same roundup that the parallel habit of convening expert panels “to deliver predetermined recommendations” does the opposite of what advisory committees exist for, which is to put independent judgment between a company’s application and the public.

There is a version of this story in which the FDA genuinely opens its doors, and the skeptics who spent years watching industry scientists wave through industry products finally get a committee system worth trusting. That version requires the agency to show its work. A press release inviting the public to apply is not the work. The work is the rule the GAO has been asking for since 2012, the one that states in writing who is too compromised to sit and who makes that call. Until the FDA publishes it, “expand the voices at the table” is a line about who gets invited, not a promise about who gets screened. The agency found thirteen years to not write that rule down. It found time, last week, for the press release.

Sources

1. FDA – Launches Nationwide Effort to Expand Scientific Expertise and Consumer Voices to Advisory Committees (Sept. 30, 2026)
2. GAO-26-107877 – FDA Advisory Committees: More Transparency Needed on Conflict-of-Interest Determinations (March 2026)
3. Healio – FDA advisory committee for peptides stocked with conflicts of interest (July 1, 2026)
4. STAT – New FDA peptide advisers could benefit from the committee’s recommendations (June 29, 2026)
5. Pharmaceutical Executive – FDA panel votes to loosen restrictions for four peptides
6. U.S. News – FDA Scientists Warn Against Expanded Peptide Access as Kennedy Reshapes Advisory Panel (July 1, 2026)
7. RAPS – FDA call for new adcomm members signals renewed interest in outside advisors
8. Fierce Pharma – Pharma employees can no longer serve on FDA advisory committees (April 2025)