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Pill Politics: Drugs and the FDA

Stephen J. Ceccoli
Pill Politics: Drugs and the FDA
ISBN: 978-1-58826-241-7
2003/211 pages/LC: 2003047045
Also of interest:  Also of interest: Health Policy by James Brasfield and Driving Down the Cost of Drugs by Ramón Castellblanch

"Well organized, written, and researched, Pill Politics clearly establishes the political nature of the FDA's drug approval process.... a welcome addition."—Kant Patel, Southwest Missouri State University

"Ceccoli tackles difficult topics clearly and succinctly.... this solid and timely study of the FDA also tests important theories in public policy and the political economy of regulation."—Kevin Buterbaugh, Southern Connecticut State University


From aspirin to Viagra to the latest cancer treatment, the Food and Drug Administration acts as a gatekeeper determining what medicines are legally available in the United States. But in fulfilling that regulatory role, Stephen Ceccoli argues, the FDA may inadvertently be promoting new drugs at the expense of public health.

The FDA's initial mandate to protect health grew out of pharmaceutical-related disasters in the early 1900s. Later criticisms that the agency's approach impeded industry competitiveness and failed to meet public need, however, led to a political compromise on its mission. The new FDA has cut its review time nearly in half and allows direct-to-consumer advertising, off-label promotion of drugs, and the "fast-tracking" of treatments. Ceccoli convincingly shows that this approval process, while redressing valid complaints, is also creating a new complex of problems that must be resolved.


Stephen J. Ceccoli is associate professor of political science at Rhodes College.


  • Putting the FDA Into Perspective.
  • The Politics of Assessing Drugs.
  • An Evolving Regulatory Balance.
  • The Drug Lag Debate and Demands for Reform.
  • A Grand Compromise and the Shift to a New Era.
  • Whither the FDA?
  • Protecting and Promoting Public Health in the United States.
  • Appendix: Drug Development and the FDA's Approval Process.