US government is not set up to A/B test the efficacy of its own agencies. You can't set up an alternative to the FDA in order to test it, because the FDA is th

US government is not set up to A/B test the efficacy of its own agencies. You can't set up an alternative to the FDA in order to test it, because the FDA is the supreme dictator over the regulatory domain, and you can't get around Mom saying "no" by asking Dad behind her back. You can, however, look at the European pharmaceuticals regime, and note that an identical drug costs three times in the US the amount it costs in France. Clearly, the FDA is not optimal. Equally clearly, we do not demand meta-studies proving that the FDA itself is safe and effective for its stated purpose.