The Food and Drug Administration is the nation’s most ubiquitous regulatory agency, overseeing everything from syringes and CT scanners to drugs, vaccines and most foods. These products account for more than $1 trillion annually, or about a quarter of U.S. consumer spending. This slow, dysfunctional agency needs drastic reform of its requirements, procedures and attitudes.

One reform Scott Gottlieb, President Trump’s nominee to lead the agency, will likely embrace is “right to try”—that is, giving terminally ill patients access to unapproved medicines. He could remove the FDA from judgments about “compassionate use” of unapproved drugs. There is already a trend in this direction: Thirty-three states have passed laws aimed at providing easier access to experimental treatments that are still in the earliest stages of human testing.

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