Among solutions suggested is six-year fixed term for the FDA commissioner and appointment of external advisory board to oversee cultural changes.

Payers would welcome any additional clarity provided by advisory panel review, given the perception, expressed in a recent ICER report, that the evidence is insufficient to determine whether the new drug is safer or more effective than erythropoiesis-stimulating agents.

Elizabeth Fowler brings combination of Capitol Hill, White House and pharma industry experience to the role of director of the Center for Medicare and Medicaid Innovation.