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Reshma Ramachandran

@reshmagar.bsky.social
1.2K followers 525 following 229 posts

Assistant Professor, primary care physician, and health services researcher at Yale School of Medicine, Co-Director of the Yale Collaboration for Regulatory Rigor, Integrity, and Transparency (CRRIT); *views expressed here are my own*

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Reposted by Reshma Ramachandran
colinbbegg.bsky.social @colinbbegg.bsky.social · 02/07/2026
Post-market studies supporting recently approved FDA drugs are increasingly using non-randomized RWE approaches, note Louis Li and colleagues, though such approached remain infrequent in the pre-market setting. @JoshuaDWallach @yalesph.bsky.social @reshmagar.bsky.social @jsross119.bsky.social
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Holly Fernandez Lynch @hollylynchez.bsky.social · 11/02/2026
Another instance of a center director acting unilaterally to overrule other staff (which here also involved ignoring FDA's previous statements to the company). As @reshmagar.bsky.social and I have argued, the bar should be much higher for such unilateral action: www.nature.com/articles/s41...
nature.com
Diffusing authority to make drug approval decisions at the US Food and Drug Administration - Nature Medicine
The US Food and Drug Administration (FDA) is at a crossroads. There is an urgent need to strengthen the integrity of drug approvals and rejections by diffusing the decision-making authority of individ...
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Doctors for America @drsforamerica.bsky.social · 14/01/2026
See @cmorten.bsky.social's extensive thread on the hearing including a link to he and @reshmagar.bsky.social's new editorial "Politics, Science, and the Future of FDA Drug Regulation: FDA’s Review of Mifepristone REMS as a Litmus Test." bsky.app/profile/cmor...
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Aaron Mitchell @thewonkologist.bsky.social · 14/01/2026
New study in @jamanetworkopen.com this week: frequency of post-market safety issues for cancer drugs with accelerated approval. Happy to collaborate on this study with Dr. Mooghali, @reshmagar.bsky.social @jsross119.bsky.social jamanetwork.com/journals/jam...
jamanetwork.com
Postmarket Safety Actions for Novel Oncology Drugs Granted Accelerated Approval
This cross-sectional study examines postmarket safety actions for novel oncology drugs that received accelerated Food and Drug Administration (FDA) approval.
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Chris Morten @cmorten.bsky.social · 12/01/2026
On Wed, Senate HELP will hold a hearing on "Protecting Women: Exposing the Dangers of Chemical Abortion Drugs"—pushing the lie that FDA's regulation has been lax. @reshmagar.bsky.social & I are in @jama.com today, on how FDA has, in fact, been (over-)careful in regulating medication abortion. 1/
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Yale CRRIT @yalecrrit.bsky.social · 22/12/2025
First announced in June, these vouchers are meant to shorten drug review to 2 mos or less. Despite current FDA leadership claiming prior inappropriate industry influence, CRRIT Co-Director @reshmagar.bsky.social noted “cut to now, and it seems like the hen has let the fox into the henhouse.”
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Reposted by Reshma Ramachandran
Yale CRRIT @yalecrrit.bsky.social · 22/12/2025
🔗 www.statnews.com/2025/12/19/f...
statnews.com
FDA voucher program has become vehicle for political interference in drug review decisions, staffers say
Two government officials told STAT that the White House has been involved in final decisions about the FDA's new priority review voucher program for drug companies.
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Reshma Ramachandran @reshmagar.bsky.social · 20/12/2025
An important piece in @nytimes.com with critical context about why overhauling the US childhood vaccine schedule to match Denmark's is a very bad idea, especially as the White House & politicians continue to strip healthcare access for millions in this country. @drsforamerica.bsky.social #MedSky
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Doctors for America @drsforamerica.bsky.social · 16/12/2025
Interview with Reshma Ramachandran on changes to the FDA’s adverse-event data releases and future directions for enhancing its safety-surveillance infrastructure. | New England Journal of Medicine @reshmagar.bsky.social www.nejm.org/do/10.1056/N...
nejm.org
Interview with Reshma Ramachandran on changes to the FDA’s adverse-event data releases and future directions for enhancing its safety-surveillance infrastructure. | NEJM
Audio Interview from the New England Journal of Medicine — Interview with Reshma Ramachandran on changes to the FDA’s adverse-event data releases and future directions for enhancing its safety-surveillance infrastructure.
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mattherder.bsky.social @mattherder.bsky.social · 19/12/2025
Classic yet alarming: the federal govt just posted in the Canada Gazette a proposal to fundamentally change drug regulation as we know it. Here's the link to the Gazette: gazette.gc.ca/rp-pr/p1/202...
gazette.gc.ca
Canada Gazette, Part 1, Volume 159, Number 51: Order Providing for Reliance on Decisions of, or Documents Produced by, Foreign Regulatory Authorities in Respect of Certain Drugs
December 20, 2025, Part 1, Volume 159, Number 51, Canada Gazette
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Sarah Karlin-Smith @sarahkarlin-smith.bsky.social · 10/12/2025
If you are following the FDA's new commissioner's national voucher program this post from Paul Kim is a must read... "No miracles here." www.linkedin.com/feed/update/...
linkedin.com
#fda #cpnv #publichealth #pdufa #kendallsquarepolicy | Paul T. Kim
Yesterday, #FDA announced its first approval under the Commissioner's National Priority Voucher (#CPNV) pilot – of a new domestic manufacturing line for a 23-year old drug. “The approval,” declared F...
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Reposted by Reshma Ramachandran
Joseph Ross @jsross119.bsky.social · 08/12/2025
New paper from @yalecrrit.bsky.social out today in @jamainternalmed.com - The 2007 US Food and Drug Administration (FDA) Amendments Act (FDAAA) expanded the agency's safety-related regulatory authorities, including enhanced postmarketing safety surveillance and new clinical study requirements (1/5)
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Reshma Ramachandran @reshmagar.bsky.social · 08/12/2025
While our @nejm.org Perspective focuses on #FAERS (FDA's passive drug safety surveillance system), the limitations to this database also apply to VAERS for vaccines. Current FDA leadership is using VAERS to make conclusions despite its many limitations & no scientific explanation. #MedSky
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Holly Fernandez Lynch @hollylynchez.bsky.social · 07/12/2025
Excited to work with @pzettler.bsky.social and @reshmagar.bsky.social on this new project supported by @arnoldventures.bsky.social with the goal of developing a principles-based approach to rebuilding and re-envisioning FDA. moritzlaw.osu.edu/ohio-state-a...
moritzlaw.osu.edu
Ohio State and Partners Secure Grant to Inform Future Vision of FDA
Researchers at The Ohio State University Moritz College of Law and partner universities were recently awarded a grant from Arnold Ventures to support a multi-faceted research project, titled “A Princi...
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Yale CRRIT @yalecrrit.bsky.social · 04/12/2025
What does this mean? -In making a single pivotal clinical trial the default for drug approval, FDA is moving away from the administration’s stated “gold science standard” that calls for a quality minimum of “replicability” and “reproducibility.” (www.whitehouse.gov/presidential...)
whitehouse.gov
Restoring Gold Standard Science
By the authority vested in me as President by the Constitution and the laws of the United States of America, including section 7301 of title 5, United
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Yale CRRIT @yalecrrit.bsky.social · 04/12/2025
ICYMI: @lizzylawrence.bsky.social in @statnews.com News scooped that the @fda.gov is planning to require only a single pivotal clinical trial to be the basis of drug approval, rather than 2 or more.
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Holly Fernandez Lynch @hollylynchez.bsky.social · 21/11/2025
When @reshmagar.bsky.social + I called for FDA to diffuse authority for drug approval decisions, this is NOT what we meant. Approval decisions should be made by those closest to the data regarding safety and effectiveness, with every possible effort to avoid real or perceived political influence.
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Sarah Karlin-Smith @sarahkarlin-smith.bsky.social · 24/11/2025
The combination of diminished staff capacity and immense pressure to use new, but unvalidated, AI tools to replace it “could jeopardize FDA’s gold standard review process, leaving ... further uncertainty about whether FDA-approved drugs work and are effective." - @reshmagar.bsky.social
insights.citeline.com
US FDA Cancer Office Keeps Hemorrhaging Staff, Most Land At Industry
Merck, Lilly, and Johnson & Johnson are some of the pharma companies who have snagged the many staff leaving the FDA’s oncology positions. The Pink Sheet estimates CDER’s oncology division is operatin...
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Yale CRRIT @yalecrrit.bsky.social · 11/11/2025
We’re excited to share a recently published article in @jamainternalmed.com, led by Emory Medical School student Ravi Dhawan investigating venture capital (VC) investing trends by academic medical centers (AMCs). (1/7)
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Senator Bernie Sanders @sanders.senate.gov · 10/11/2025
Tonight was a very bad night.
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Reshma Ramachandran @reshmagar.bsky.social · 07/11/2025
Lots of thoughts regarding today's White House announcements on drug pricing policies for GLP-1s and the Medicaid drug pricing model. But clouding all of this are the 4 patients I saw today in clinic who asked me about food pantries due to their SNAP benefits being cut and... #MedSky
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Rachel Sachs @rachelsachs.bsky.social · 06/11/2025
There are a lot of very interesting design choices in this model. A brief thread. 1/4
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Holly Fernandez Lynch @hollylynchez.bsky.social · 22/10/2025
Here's how @reshmagar.bsky.social and I put the same sentiment in the LA Times this weekend: www.latimes.com/opinion/stor.... But that's one difficulty with this FDA, a disconnect between what they say and what they seem willing to do.
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Holly Fernandez Lynch @hollylynchez.bsky.social · 08/10/2025
New from @pzettler.bsky.social @reshmagar.bsky.social + me in @jhppl.bsky.social. We describe themes driving historic FDA reforms, explain how what's happening under Trump2 is different + call for principles to guide FDA reform and activity across administrations. read.dukeupress.edu/jhppl/articl...
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mattherder.bsky.social @mattherder.bsky.social · 15/10/2025
I'm hiring a Legal Research Fellow! dal.peopleadmin.ca/postings/19632 CC @roojinhabibi.org @drximebena.bsky.social @elstorreele.bsky.social @cmorten.bsky.social @gregggonsalves.bsky.social @reshmagar.bsky.social @hollylynchez.bsky.social @akapczynski.bsky.social @fatimahassan.bsky.social
dal.peopleadmin.ca
Research Fellow
Working in close collaboration with the Chair in Applied Public Health, the Infectious Disease Innovation Governance (IDIG) Research Fellow will play a leading role in a variety of research and capaci...
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Holly Fernandez Lynch @hollylynchez.bsky.social · 19/10/2025
In this am's @latimes.com, @reshmagar.bsky.social + I have an op-ed raising concerns abt pressure to approve rare disease drugs no matter how weak the evidence. Flexibility is reasonable but FDA approval must mean more than “this drug has not been shown not to work." www.latimes.com/opinion/stor...
latimes.com
Contributor: By loosening standards, the FDA isn't doing rare-disease patients any favors
It’s reasonable to assess rare-disease drugs differently. That’s why the FDA has been remarkably flexible about these approvals for decades. But some treatments just aren't any good.
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Sarah Karlin-Smith @sarahkarlin-smith.bsky.social · 20/10/2025
Coupling existing regulatory flexibility with a faster review “is concerning because that just means that, not only will they lower the bar for what type of evidence will be required … but also on top of that they’re going to have reviewers be less careful ..." @reshmagar.bsky.social
insights.citeline.com
First Cohort Shows Many Routes To US FDA’s Commissioner’s National Priority Voucher
Experts raised concerns about the pilot program's larger than expected size and the lack of transparency about the reasons the cohort deserved vouchers over a pool that the FDA said included hundreds ...
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Holly Fernandez Lynch @hollylynchez.bsky.social · 20/09/2025
Here's our new article reporting findings from stakeholder interviews in which we hoped to learn what it takes to successfully complete rigorous confirmatory studies after accelerated approval. Instead, we mostly heard willingness to trade rigor for feasibility. 1/ academic.oup.com/healthaffair...
academic.oup.com
Flexibility Over Rigor: Stakeholder Acceptance of the Limitations of Confirmatory Studies Following Accelerated Approval
Despite the importance of postmarketing requirements (PMRs) following accelerated approval and well-recognized shortcomings in their rigor and timeliness,
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Meg Tirrell @megtirrell.bsky.social · 03/09/2025
1,000+ HHS employees (current & former) call for RFK Jr’s resignation www.cnn.com/2025/09/03/h...
cnn.com
HHS employees demand RFK Jr. resign for ‘compromising the health of this nation’ | CNN
More than 1,000 current and former employees of the US Department of Health and Human Services wrote a letter to Secretary Robert F. Kennedy Jr. on Wednesday, arguing that his leadership has “put the ...
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Daniel G. Aaron, MD, JD @medlawdan.bsky.social · 28/08/2025
Thrilled to announce an upcoming symposium at Utah Law (@sjquinney.bsky.social): Fireproofing the FDA: Power, Politics, and Public Health Free to register and featuring @deankronkwarner.bsky.social @saragerke.bsky.social @ghorvath.bsky.social . . . www.law.utah.edu/event/lee-e-...
law.utah.edu
Lee E. Teitelbaum Utah Law Review Symposium – Fireproofing the FDA: Power, Politics, and Public Health - S.J. Quinney College of Law
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Yale CRRIT @yalecrrit.bsky.social · 16/08/2025
User fees have had a critical role in funding @fda.gov since 1992. In our new @nejm.org Perspective, we outline the history and intent of PDUFA, & suggest potential reforms to the PDUFA VIII negotiation process to enable transparency & promote patient-centeredness (1/3)
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Aaron Mitchell @thewonkologist.bsky.social · 28/08/2025
Cancer drugs with Accelerated Approval have to undergo confirmatory clinical trials. What happens when the confirmatory trial fails, showing no clinical benefit? Does the manufacturer stop promoting the drug to doctors? We took a look: pubmed.ncbi.nlm.nih.gov/40855611/ 1/
pubmed.ncbi.nlm.nih.gov
Industry promotion of oncology drugs with accelerated approval that failed confirmatory trials - PubMed
Industry payments to physicians influence prescribing, raising concern for drugs granted accelerated approval that failed confirmatory studies. We measured industry payments for oncology drugs granted...
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Reshma Ramachandran @reshmagar.bsky.social · 12/08/2025
Great piece from @statnews.com @caseyross.bsky.social @bobjherman.bsky.social @tarabannow.bsky.social @lizzylawrence.bsky.social on how UnitedHealth has published misleading research on Medicare Advantage in peer-reviewed medical journals for its lobbying efforts: www.statnews.com/2025/08/11/u...
statnews.com
Inside the research machine that helps UnitedHealth protect its Medicare profits
A STAT Investigation: Inside the research machine that helps UnitedHealth protect its Medicare profits.
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Yale CRRIT @yalecrrit.bsky.social · 01/08/2025
This team comprised of @yaleschoolofmed.bsky.social Alissa Chen, @keckschoolusc.bsky.social Yixuan Liang, @yaleschoolofmed.bsky.social Kasia Lipska, and CRRIT Co-Directors @jsross119.bsky.social and @reshmagar.bsky.social Full analysis: link.springer.com/article/10.1...
link.springer.com
Exclusion of Older Adults from Obesity Treatment Pivotal Trials of GLP-1RAs and GIP/GLP-1RAs - Journal of General Internal Medicine
Journal of General Internal Medicine -
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Holly Fernandez Lynch @hollylynchez.bsky.social · 06/08/2025
What should we infer from the fact that the company refuses to release its complete response letter while insisting that FDA is being unreasonable? I agree with @reshmagar.bsky.social: "I’m a little doubtful about the narrative." www.statnews.com/pharmalot/20...
statnews.com
After 'conflicting' signals from FDA, rare disease drugmaker contemplates closure
Stealth BioTherapeutics, which has been developing a rare disease drug, said it is making contingency plans to close the company after getting "conflicting" signals from the FDA.
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Yale CRRIT @yalecrrit.bsky.social · 30/07/2025
In a recently published article in @bmj.com, @yaleschoolofmed.bsky.social student Tiffany Jiang, CRRIT Co-Director @reshmagar.bsky.social & Joshua Skydel (Yale Rheumatology) investigate how eliminating these requirements can increase access to biosimilars (2/2) 🔗 www.bmj.com/content/390/...
bmj.com
Regulatory change could improve biosimilar access in the US
Tiffany E Jiang , Reshma Ramachandran , and Joshua J Skydel argue that US requirements for interchangeability are not supported by evidence and hamper use of biosimilars Biological medicines (biologi...
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Reshma Ramachandran @reshmagar.bsky.social · 22/07/2025
Very comprehensive and great summary of yesterday's FDA Expert Panel on SSRIs in pregnancy and how several panelists raised doubts about SSRIs overall. No FDA scientists presented nor is there a public comment opportunity. So much for #radicaltransparency. www.nbcnews.com/health/menta... #MedSky
nbcnews.com
FDA panel promotes misinformation about antidepressants during pregnancy, psychiatrists say
Nearly all of the 10 panelists emphasized what they said were risks of the drugs. Some claimed, without evidence, that antidepressants don't work at all.
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Chris Morten @cmorten.bsky.social · 22/07/2025
New blog post from me in @lpeblog.bsky.social! Quick thread below! lpeproject.org/blog/whats-v... 1/
lpeproject.org
What’s Value in Health Care? Powerful Companies Make It Hard To Know
Powerful health care companies shape the informational environments around their products. As part of this playbook, companies avoid or thwart the generation and dissemination of accurate information…
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Reshma Ramachandran @reshmagar.bsky.social · 16/07/2025
ICYMI: Great piece by @matthewherper.bsky.social in @statnews.com on how the new FDA Commissioner too often hypes and misleads about his plans for FDA that on further scrutiny are not much or not possible. Hoping for less PR and more substance moving forward. www.statnews.com/2025/07/14/f... #MedSky
statnews.com
The FDA commissioner is a gifted talker — but the job is about more than that
FDA Commissioner Marty Makary's vision for the agency risks the best of an agency that mostly has functioned well for the sake of an uncertain payoff.
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Yale CRRIT @yalecrrit.bsky.social · 15/07/2025
CRRIT Co-Director @reshmagar.bsky.social provided public comments at the Prescription Drug User Fee Act (PDUFA) VIII Kickoff Meeting @fda.gov yesterday. Dr. Ramachandran discussed how the user fee process could be reformed to be more patient-centered & transparent.
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Center for Science in the Public Interest @cspinet.org · 11/07/2025
After massive job cuts, FDA is in freefall. "You have to have a deep cynicism about what these workers are doing to believe that fewer of them is better,” says CSPI President @drpeterlurie.bsky.social. w/ @drjoshs.bsky.social, @jsross119.bsky.social‬, @reshmagar.bsky.social, @robcaliff.bsky.social
nytimes.com
Inside the Collapse of the F.D.A.
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Yale CRRIT @yalecrrit.bsky.social · 10/07/2025
Surrogate markers are increasingly being used to support @fda.gov approvals instead of measuring clinical outcomes. In a @scientistsorg.bsky.social memo @reshmagar.bsky.social, Joshua Wallach & @jsross119.bsky.social outline how FDA can make transparent & strengthen evidence. fas.org/publication/...
fas.org
Validating Surrogate Endpoints to Support FDA Drug Approval
As surrogate markers are increasingly being accepted by FDA to support approval of new drugs and biologics, it is imperative that patients and clinicians understand whether such novel endpoints are re...
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Reshma Ramachandran @reshmagar.bsky.social · 10/07/2025
This is welcome news but will the @fda.gov post complete response letters (denial letters) for drugs and biologics that ultimately were not approved and subsequent denials occurring now? Why limit the release to only those approved? www.fda.gov/news-events/... #MedSky
fda.gov
FDA Embraces Radical Transparency by Publishing Complete Response Letters
The FDA today published more than 200 decision letters, known as complete response letters (CRLs).
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Chris Morten @cmorten.bsky.social · 08/07/2025
RFK Jr. has used the FDA's unnecessary secrecy as a PR cudgel, painting a lifesaving agency full of dedicated, expert public servants as hopelessly captured & corrupt. This is a dark time. My clinic & clients, including @drsforamerica.bsky.social, remain committed to protecting FDA's essential work.
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Chris Morten @cmorten.bsky.social · 08/07/2025
@reshmagar.bsky.social, @jsross119.bsky.social & @akapczynski.bsky.social & I wrote in 2021 that "Reforming [FDA's] data-sharing practices is essential to combating future vaccine misinformation and preventing public mistrust of the FDA from festering further." www.washingtonpost.com/opinions/202...
washingtonpost.com
Opinion | 55 years to fulfill a records request? Clearly, the FDA needs serious reform of its data-sharing practices.
The FDA's glacial time frame for releasing documents on the Pfizer/BioNTech vaccine is only the latest evidence that the agency needs some major changes.
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Chris Morten @cmorten.bsky.social · 08/07/2025
Must-read story from @jeneeninterlandi.bsky.social on Trump & RFK Jr's catastrophic assault on the FDA. I'm quoted briefly, echoing a warning @reshmagar.bsky.social, @drjoshs.bsky.social & other watchdogs reiterated for years: FDA's unnecessary, excessive secrecy fueled conspiracy theories.
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Doctors for America @drsforamerica.bsky.social · 08/07/2025
“It is heartening to see that the court agrees with doctors, researchers, and patients that the government cannot unlawfully and without explanation remove crucial health information and datasets." @reshmagar.bsky.social www.fiercehealthcare...
fiercehealthcare.com
Judge vacates Trump administration's removal of health web pages
A federal judge ruled that the swift takedown of health information across several government webpages earlier this year was illegal and vacated agencies’ directives to do so. | January's abrupt removals of public health webpages and datasets to comply with an executive order on gender and sex were a case of "government officials acting first and thinking later," a federal judge wrote in his ruling.
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Doctors for America @drsforamerica.bsky.social · 08/07/2025
“The F.D.A. meets with industry hundreds of times over the user-fee renewals, and only half a dozen or so times with the rest of us. Whether it’s conscious or deliberate or not, what you see over time is that industry’s priorities become agency priorities.” @reshmagar.bsky.social
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Doctors for America @drsforamerica.bsky.social · 08/07/2025
"Approving drugs quickly and with less evidence might give doctors and patients more options, but it also shifted a huge burden of uncertainty from the agency onto them." @reshmagar.bsky.social www.nytimes.com/2025/07/08/m...
nytimes.com
Inside the Collapse of the F.D.A.
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Reshma Ramachandran @reshmagar.bsky.social · 08/07/2025
Honored to have @yalecrrit.bsky.social's work featured in this excellent @nytimes.com Mag piece on the ongoing assault and decimation of @fda.gov. There is no doubt the agency is imperfect but taking a sledgehammer to our national regulator is not the way. www.nytimes.com/2025/07/08/m... #MedSky
nytimes.com
Inside the Collapse of the F.D.A.
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