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HEALTH NEWS

New FDA Chief Predicts Major Shift in Healthcare

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 27 September, 2005  00:08 GMT

The incoming head of the Food and Drug Administration says the agency must stay on top of emerging discoveries into the mechanisms of disease that may lead to new treatments that can be tailored to individual patients.

Dr. Andrew C. von Eschenbach, tapped by President Bush to at least temporarily head the regulatory agency, said Sunday that recent research will lead to a new kind of healthcare.

"We are discovering so much about diseases like cancer at the molecular level," von Eschenbach, a urologic surgeon by training, said in an interview with The Associated Press.

Based on these understandings, physicians will be able to devise treatments more effectively matched to a specific patient and his or her condition, he said. That's a fundamental shift: Doctors now treat illnesses based primarily on how well other people have responded to a given treatment.

Ambitious Goal

Von Eschenbach has a reputation for optimism. As head of the National Cancer Institute, he outlined an ambitious goal of eliminating suffering and death due to cancer and turning it into a manageable disease by 2015 -- an aim regarded by some as unlikely.

But von Eschenbach has seen cancer from both sides, having survived three diagnoses: melanoma, prostate cancer and basal cell carcinoma.

Von Eschenbach said he will stay in his post at the institute, which is the government's lead agency in researching cancer treatments, while running the FDA. He gave no indication whether he expected to be nominated as permanent chief of the FDA.

He replaces Commissioner Lester Crawford, out only two months after the Senate confirmed him for the post. Crawford had functioned as acting head for more than year.

Crawford's surprise resignation Friday gave no specific reason for his departure. His tenure was marked by increasing criticism of the agency by those who contended it had become more interested in politics or benefiting drug companies than in its mission to protect consumers.

Perpetual Challenge

Von Eschenbach declined to discuss in detail specific cases that have led to criticism of the FDA. They include Vioxx, one of a class of painkillers lately tied to heart problems, and Plan B, an emergency, morning-after contraceptive that the FDA has yet to approve for over-the-counter sales, despite assurances it is safe.

Von Eschenbach had only praise for his colleagues at the FDA, calling the agency the "gold standard" for food and healthcare regulation.

"I have an enormous amount of respect, admiration and appreciation for them," he said, and will continue many of his predecessors' initiatives while looking for ways to improve agency operations.

Von Eschenbach also discussed the perpetual challenge for the FDA: speeding new treatments to the market while ensuring they are safe. Sometimes those values are in conflict, as pressure from drug companies and patients to make new treatments available run up against incomplete or ambiguous safety data.

"I believe very strongly that science has to drive and is the driver of our knowledge and our understanding, and therefore of our decisions," he said. "Where science is incomplete, we continue to believe that under any circumstances, do no harm."

But with new treatments, von Eschenbach said: "I believe it's still important to ask the question, 'How can we accelerate the timeline? How can we make certain we are getting these interventions to the patients as quickly as possible?'"

The Philadelphia native served as chief academic officer of the University of Texas MD Anderson Cancer Center in Houston before taking over the National Cancer Institute in 2002.




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