Scott Alexander reviews comments on his posts about aducanumab and the FDA, acknowledging some mistakes while defending his overall critique of FDA conservatism. Longer summary

Scott Alexander reviews comments on his recent posts about aducanumab and the FDA. He acknowledges some mistakes in his original post, but defends his overall critique of the FDA as overly conservative. The comments cover various aspects of drug approval, including the aducanumab controversy, surrogate endpoints, the FDA's impact on small biotech companies, and comparisons to other regulatory systems. Scott reflects on how to improve his fact-checking process while still writing passionate pieces. Shorter summary

Scott Alexander argues that the FDA is too strict, not too lax, and proposes unbundling FDA approval to allow for more nuanced drug regulation. Longer summary

Scott Alexander criticizes an Atlantic article that argues for stricter FDA standards following the approval of aducanumab, an Alzheimer's drug with questionable efficacy. He contends that the FDA is already too strict, citing examples like the delayed approval of COVID-19 tests and vaccines. Scott argues that the FDA's excessive caution has likely cost many lives. He proposes unbundling FDA approval into separate decisions about legality, insurance coverage, and the FDA's endorsement level. This would allow for more nuanced approvals and potentially reduce costly mistakes while still permitting access to promising treatments. Shorter summary