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All In Interview - Marty Makary - Recap and Notes - January 15 2026

January 15 2026

  • FDA Commissioner
  • In San Francisco for JPM Health Conference
  • Hospital Price Transparency
  • Sociology of Medical Dogma
  • FDA wastage
    • 2000 HR people before he got there
    • 1500 IT people before he got there
    • 20000 employees total before he got there
    • Previous commissioner’s first priority was to fight misinformation - new priority is to deliver better care and healthier food
  • Accelerating drug approvals
    • Eliminating/reducing animal trials
      • Animal testing might not help - in fact can hurt
      • Computational models can fix it
    • Might want to introduce continuous trials
    • Planning to allow use of Bayesian statistics
    • Safety-ism has hurt people by delaying access to medication
  • Surprises
    • Each of the centers had their own silos - a guy would move documents from 1 center to another because of lawyer requirements
    • 1 guy was the ink guy on the fax machine
    • All cleaned up
  • Food pyramid
    • Everyone knows it was backwards - was wrong - childhood obesity was off the charts
    • Too much chronic sugar
    • Farming techniques also matter
    • Importance of protein
    • Real food
  • GLP-1s
    • 40% of American kids have chronic disease - we failed our kids
  • Funding and NIH
    • Claims no money dropped in NIH funding - its more just reallocation and zero-based budgeting
    • 14% of NIH grants went to DEI research previously
    • Jay Bhattacharya is doing a great job with NIH
  • Vaccines
    • Friedberg’s family declined Hep-B vaccine for his child
    • Have created a hierarchy of vaccines so that people will actually vaccinate more
    • How to deal with CA DPH rebellious nature
  • Drug prices
    • MFN status pricing should help drug prices drop here
    • US has been financing 60% of the cost of Pharma R&D - this means other countries will pay more - they need to pay their fair share
    • Most antibiotics people take in US should not be prescribed
    • Biden administration sent out zero enforcement letters - new admin sent out 1500 or so enforcement letters
    • Gras - generally recognized as safe
  • Autism
    • 1 in 12 boys in CA diagnosed with autism
    • Most chronic diseases are from general body inflammation
      • This needs to be understood better
  • Looking forward
    • Hoping to help alleviate PTSD
    • Universal flu shot?

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