Conflicts of Interest on Committees of Experts: The Case of Food and Drug Administration Drug Advisory Committees

Governments and firms often use committees of experts to help them make complex decisions, but conflicts of interest could bias experts' recommendations. We focus on whether financial ties to drug companies bias Food and Drug Administration (FDA) drug advisory committee (AC) members' voting on drug approval recommendations. Using the FDA's narrow measure of conflicts, we find a consistent but weak positive relation between conflicts and voting for approval. Using a broader measure, we find a significant negative relation. We find stronger evidence that experts' characteristics, such as expertise level, drive voting. We also show that a congressional act that effectively excludes conflicted AC members resulted in a sharp drop in average AC members' expertise and an unintended increase in voting for approval. Our results have implications for eliminating financial conflicts from medical decisions, which could reduce the level of expertise of the decision makers and lead to unexpected voting tendencies.