FDA nominee faces Senate fight over Plan B

The nomination renews concerns about drug safety, emergency contraception.

By David Glendinning — Posted April 10, 2006

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Washington -- President Bush has tapped acting Food and Drug Administration Commissioner Andrew C. von Eschenbach, MD, to fill the permanent post at the agency, touching off a potentially contentious Senate confirmation process.

Dr. von Eschenbach has been acting FDA chief since last September, when he gave up his day-to-day duties as National Cancer Institute director to replace former commissioner Lester Crawford, DVM, PhD. Becoming the permanent leader of the agency would require approval from the upper chamber.

"Andy is an inspired choice to provide permanent leadership at this critical agency," said Health and Human Services Secretary Michael Leavitt.

"His career has been defined by his vision for progress in research and passion for the care of patients, two qualities which will serve the agency and the American public well."

But Senate approval might prove tricky for the White House, which lobbied for months to confirm Dr. Crawford only to see him resign under questionable circumstances less than three months later. The president's allies on Capitol Hill are not eager to go through a repeat of such a draining fight if the candidate's potential longevity in the position is in any doubt, congressional aides familiar with the approval process said.

The FDA post also has become a touchstone for a debate over the controversial emergency contraceptive known as Plan B. Several Democratic senators held up Dr. Crawford's nomination until receiving assurances from the Bush administration that it would issue a ruling on whether the drug would receive an over-the-counter designation. The FDA, however, later delayed its decision despite these assurances.

Within hours of the White House naming Dr. von Eschenbach for the permanent position, Sens. Hillary Rodham Clinton (D, N.Y.) and Patty Murray (D, Wash.) announced that they would block the nominee until they are satisfied that the administration will move forward on the Plan B issue. The nomination cannot proceed to a full vote until the senators release the hold.

President Bush's choice also has generated controversy among critics who said Dr. von Eschenbach would relax FDA safety standards in the pursuit of faster drug approvals. The decision smacks of cronyism on the part of the administration that could end up being harmful to patients, said Sidney M. Wolfe, MD, director of the health research group for Public Citizen, a consumer rights organization based in Washington.

"If confirmed by the U.S. Senate to be the next commissioner of the Food and Drug Administration, Dr. Andrew von Eschenbach will become yet another Bush appointee whose main reason for being selected is that he is a family friend, someone who has been warmly embraced by the regulated industries, especially the pharmaceutical industry, and someone who has been and will continue to be loyal to the White House agenda," he said.

Dr. von Eschenbach was not available for comment.

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