Not even a year after the US Food and Drug Administration announced it was using generative AI to speed up the drug review process, the agency has another bold announcement: employees who make quick work of their assignments will be handsomely rewarded for their dedication.
According to the Associated Press, FDA commissioner Marty Makary recently unveiled a new “pilot program” involving cash bonuses for drug reviewers who complete their work ahead of schedule.
The reward for fast regulatory work will come in the form of a quarterly bonus, to be paid out to FDA staffers starting in August. Per the AP, payment amounts will be based on vague “weighted time savings,” as well as “work quality and work complexity.”
“My job as your commissioner is to be your advocate and to fight for you,” Makary told drug reviewers in a presentation viewed by the AP. “If you don’t like it, we can get rid of it, but usually everybody loves money.”
What all of this means in practice is unclear. Never before in its history has the FDA paid staff according to speed or performance metrics, so there are likely to be some negative consequences. Once the system goes live, the FDA will essentially be paying its drug reviewers to approve applications faster in order to receive a financial reward — a conflict of interest that will all but guarantee increased reliance on the agency’s error-prone AI system.
Beyond that obvious ethical morass, there’s also the question of how the bonus will be distributed, given that some teams of drug reviewers are made up of large numbers of contributors and other auxiliary personnel.
All this comes as the FDA’s drug and biologics centers have shed nearly 20 percent of its workforce since Donald Trump took office in 2025. Led by draconian cuts from Health and Human Services secretary Robert F Kennedy Jr, the mass exodus is just the latest in a long history of setbacks for an FDA which has struggled to maintain funding while fighting to maintain independence from the incredibly powerful pharmaceutical lobby.
What this new reward system means for US consumers is anybody’s guess, but it’s sure to be a bumpy ride.
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