It’s hard enough to run a clinical trial guys. It literally costs $100 million at a minimum, yet the requirements that make it cost this much are not enough. We are basically going to regulate new medicine out of existence.
An interesting point he made was that in the wake of the Thalidomide (https://en.wikipedia.org/wiki/Thalidomide) scandal, the FDA started requiring drugs to be both safe _and effective_
https://www.fda.gov/about-fda/histories-product-regulation/p...
The 'effective' part has proven to be a big source of complexity in the following years, because while it's relatively easy to prove a drug is relatively safe, it's much more difficult and subjective to prove a drug is effective. That closes off a lot of areas of research and development.
The kicker is that Thalidomide was never sold in the USA to begin with.
Anyway, as any reader can imagine, there would be a lot of negative social outcomes to allowing the sale of ineffective drugs. There's a lot of trouble now with medical devices and drugs not being effective, even though we have the rule. I'm not against regulation, I think medical sales are a really complex issue and I don't know how to even judge where the right balance of safety/effectiveness and innovation/freedom could be.
(I point this out because most people only tell the very first part of the thalidomide story).