The White House seems to have selected FDA Acting Commissioner Lester Crawford, PhD/DVM, as its choice to fill the commissioner slot on a permanent basis.

Crawford is understood to have met with President Bush Jan. 27. While the Administration typically retains tight control of personnel decisions, the meeting suggests that an announcement might not be far off.

The FDAer is said to have the support of a number of key senators, including Utah Republican Orrin Hatch. With the confirmation of former Utah Gov. Michael Leavitt as HHS secretary Jan. 26, Hatch's support is particularly important (¹ Also see "In Critical Climate, Leavitt Pledges to Maintain FDA “Brand” Integrity" - Medtech Insight, 24 January, 2005., p. 6).

Further, Crawford already has undergone an FBI background check and is widely recognized by industry and Capitol Hill staff - factors that might make him more swiftly confirmed by the Senate.

During his own confirmation hearing Jan. 18, Leavitt fielded senators' queries on President Bush's timeline for an FDA commissioner. Leavitt responded: "My sense is that it will happen soon."

Crawford has been acting head of FDA since Mark McClellan, MD/PhD, left the agency to take over CMS last spring. McClellan and Crawford's tested working relationship might bode further cross-agency initiatives regarding technology approval and coverage decisions.

Crawford is serving a second stint as acting FDA chief, having held the same title from February to November of 2002, when McClellan was sworn in. A quality systems expert, especially on food safety, Crawford had been short-listed prior to the choice of McClellan.

In recent months, Crawford has contended with a number of high-profile issues, including the Vioxx and pediatric antidepressant incidents, which sparked negative publicity for the agency. Largely in response to controversy over drug adverse events, he authorized an Institute of Medicine study of the drug safety system. Additionally, Crawford has defended FDA's role in intervening in tort cases on behalf of drug and device firms when agency decisions are challenged (² Also see "Crawford Announces New Ad Policy Group, Defends FDA Court Interventions" - Medtech Insight, 9 August, 2004., p. 10).

FDA Commish Pick Imminent? Crawford Finally May Shed Understudy Role

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