Acting FDA director von Eschenbach not considered likely candidate for job

Drug Store News,  Oct 10, 2005  

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WASHINGTON -- Even though the White House was quick to name an acting commissioner in Andrew von Eschenbach, current director of the National Cancer Institute, following the resignation announcement of Lester Crawford as Food and Drug Administration commissioner, von Eschenbach is considered a long shot for a permanent position in the post.

A lot of that, speculation, is driven by von Eschenbach's wish to assume the acting commissioner role and retain his role as director of NCI. Many see that as a potential lack of commitment to the FDA post.

In addition, von Eschenbach has promised to speed drug approvals, especially for patients facing terminal diseases who are more willing to accept greater risks when it comes to adverse events associated with medicines. This would seem to run contrary to one of the prevailing criticisms that von Eschenbach's predecessor frequently faced--the FDA was more interested in meeting the needs of the pharmaceutical industry when it came to safety than it was in protecting the public from potentially unsafe drugs.

As of yet, however, there is no official or unofficial short list of candidates for the top spot in the FDA.

Filling that post is a thorny problem the Bush administration has had to solve twice before--first pushing through the nomination of Mark McClellan and, after promoting McClellan to lead the Centers for Medicare and Medicaid Services, Crawford. Nominate an FDA veteran like the capable Janet Woodcock, current deputy commissioner for operations, and the critics would decry the nomination of an insider. A similar situation would develop should a pharmaceutical executive be named.

Although political appointees who were nixed on their first go around rarely get a second bite of the apple, Vanderbilt University's Dr. Alistair Wood, current chairman of the FDA's nonprescription drug advisory, committee, may be a more attractive candidate today than he was four years ago. In 2001, when Wood was nominated with the full support of Sen. Bill Frist, R-Tenn., Wood's candidacy was negatively impacted by his reputation for potentially being an overly aggressive safety regulator.

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