Freakonomics Radio 659. Can Marty Makary Fix the F.D.A.?
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Jan 16, 2026 
Marty Makary, a prominent physician-scientist and FDA Commissioner, passionately discusses pivotal healthcare reforms. He critiques historical FDA failures, like OxyContin's approval, and the impact of outdated medical dogmas on allergies and dietary advice. Makary emphasizes his agenda for faster drug approvals and price transparency, while tackling misleading prescription ads. He also highlights innovative approaches using AI and organ-on-chip technology for drug testing. Listeners gain insight into his bold vision to cure diabetes and improve public health.
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FDA's Massive Reach And Need For Diagnosis
- The FDA regulates roughly 20% of the U.S. economy and has many broken areas needing reform.
- Marty Makary emphasizes diagnosing problems before prescribing changes to fix regulatory dogma.
Peanut Advice Backfired
- Makary recounts the peanut allergy dogma that advised delaying peanuts until age three.
- That advice backfired because early exposure promotes immune tolerance and reduces allergies.
OxyContin As Regulatory Capture Example
- Makary calls the OxyContin approval a moment of regulatory capture by industry.
- He highlights short studies and a revolving door as causes of that failure.
