Oh, and one more thing. I recently learned that the FDA does not require that a new drug be more effective than existing drugs – it only requires that it be more effective than placebo.

There is so much talk about the need for innovation – when companies can maximize profits with minimal risk by making me too drugs because the FDA doesn't require them to make drugs that are better than what we already have, is it any wonder we don't have more novel therapies?

If I had to pick one change that I thought would get the biggest bang for the buck in terms of increasing innovation, that would be it – the FDA should require that new drugs be more effective and, preferably, (a girl can dream, can't she?) Have fewer side effects than existing drugs. That would be one way to end the me too drugs, wouldn't it?

Addendum: or even, in the case of something like levodopa, which is extremely effective until it becomes unbearable, the FDA could require that something be as effective, not more effective, but also require that side effect profile be much more manageable.