Study Finds Declining FDA Advisory Committee Use, Conflict Concerns

FDA's use of advisory committees has declined since 2010, while recent research suggests financial conflicts of interest among committee members have increased after an earlier decline, according to a systematic review published in the 10/29 JAMA Network Open.

Researchers from Yale University and other institutions examined 146 studies published between 1974 and 2025 evaluating the operation, composition and influence of advisory committees across HHS agencies. FDA dominated the research, accounting for 132 studies (90.4%). Of those examining FDA committees, 88 addressed CDER, 35 CDRH and 34 CBER, with some studies covering multiple centers.

The researchers found that FDA continued to rely on advisory committees but convened them less frequently after 2010, particularly for drugs, medical devices and tobacco products. Committee utilization also varied substantially across product categories.

The review also identified renewed concerns about financial conflicts of interest. Studies documented a substantial reduction in conflicts following the FDA Amendments Act of 2007, followed by more recent increases. The researchers also identified evidence suggesting that financial relationships may influence committee voting and agency decisions.

Despite these concerns, FDA decisions generally mirrored advisory committee recommendations in more than 75% of meetings examined in the underlying research. Concordance was particularly high for medical product approval decisions and when committee members demonstrated greater agreement in their votes.

The authors concluded that declining and inconsistent committee use, continuing conflict-of-interest concerns and limited evidence about regulatory outcomes point to opportunities for reform.

The latest study comes on the heels of an analysis last month by two University of Southern California policy researchers that finds that between 2013 and 2022, some 38% of FDA advisory committees included either a patient or consumer representative with active ties to an advocacy organization funded by a drug company (see earlier story). Writing in an open-source article for Project Hope, the researchers say that for several of the advisory committees, the share of meetings with potential patient or consumer conflicts was over 50%.