History of Food and Drug Regulation in the United States
Marc T. Law, University of Vermont
Throughout history,
governments have regulated food and drug products. In general, the
focus of this regulation has been on ensuring the quality and safety
of food and drugs. Food and drug regulation as we know it today in
the United States had its roots in the late nineteenth century when
state and local governments began to enact food and drug regulations
in earnest. Federal regulation of the industry began on a large scale
in the early twentieth century when Congress enacted the Pure Food
and Drugs Act of 1906. The regulatory agency spawned by this law
– the U.S. Food and Drug Administration (FDA) – now directly
regulates between one-fifth and one-quarter of U.S. gross domestic
product (GDP) and possesses significant power over product entry, the
ways in which food and drugs are marketed to consumers, and the
manufacturing practices of food and drug firms. This article will
focus on the evolution of food and drug regulation in the United
States from the middle of the nineteenth century until the present
day.
General Issues in Food and Drug Regulation
Perhaps the most
enduring problem in the food and drug industry has been the issue of
“adulteration” – the cheapening of products through the
addition of impure or inferior ingredients. Since ancient times,
producers of food and drug products have attempted to alter their
wares in an effort to obtain dear prices for cheaper goods. For
instance, water has often been added to wine, the cream skimmed from
milk, and chalk added to bread. Hence, regulations governing what
could or could not be added to food and drug products have been very
common, as have regulations that require the use of official weights
and measures. Because the adulteration of food and drugs may pose
both economic and health risks to consumers, the stated public
interest motivation for food and drug regulation has generally been
to protect consumers from fraudulent and/or unsafe food and drug
products.
From an economic
perspective, regulations like these may be justified in markets where
producers know more about product quality than consumers. As Akerlof
(1970) demonstrates, when consumers have less information about
product quality than producers, lower quality products (which are
generally cheaper to produce) may drive out higher quality products.
Asymmetric information about product quality may thus result in lower
quality products – the so-called “lemons” – dominating the
market. To the extent that regulators are better informed about
quality than consumers, regulation that punishes firms that cheat on
quality or that requires firms to disclose information about product
quality can improve efficiency. Thus, regulations governing what can
or cannot be added to products, how products are labeled, and whether
certain products can be safely sold to consumers, can be justified in
the public interest if consumers do not possess the information to
accurately discern these aspects of product quality on their own.
Regulations that solve the asymmetric information problem benefit
consumers who desire better information about product quality, as
well as producers of higher quality products, who desire to segment
the market for their wares.
For certain products,
it may be relatively easy for consumers to know whether or not they
have been deceived into purchasing a low quality product after
consuming it. For such goods, sometimes called “experience goods,”
market mechanisms like branding or repeat purchase may be adequate to
solve the asymmetric information problem. Consumers can “punish”
firms that cheat on quality by taking their business elsewhere (Klein
and Leffler 1981). Hence, as long as consumers are able to identify
whether or not they have been cheated, regulation may not be needed
to solve the asymmetric information problem. However, for those
products where quality is not easily ascertained by consumers even
after consuming the product, market mechanisms are unlikely to be
adequate since it is impossible for consumers to punish cheaters if
they cannot determine whether or not they have in fact been cheated
(Darby and Karni 1973; McCluskey 2000). For such “credence goods,”
market mechanisms may therefore be insufficient to ensure that the
right level of quality is delivered. Like all goods, food and drugs
are multidimensional in terms of product quality. Some dimensions of
quality (for instance, flavor or texture) are experience goods
because they can be easily determined upon consumption. Other
dimensions (for instance, the ingredients contained in certain foods,
the caloric content of foods, whether or not an item is “organic,”
or the therapeutic merits of medicines) are better characterized as
credence goods since it may not be obvious to even a sophisticated
consumer whether or not he has been cheated. Hence, there are a
priori reasons to believe that market forces will not be adequate
to solve the asymmetric information problem that plagues many
dimensions of food and drug quality.
Economists have long
recognized that regulation is not always enacted to improve
efficiency and advance the public interest. Indeed, since Stigler
(1971) and Peltzman (1976), it has often been argued that regulation
is sought by specific industry groups in order to tilt the
competitive playing field to their advantage. For instance, by
functioning as an entry barrier, regulation may raise the profits of
incumbent firms by precluding the entry of new firms and new
products. In these instances of “regulatory capture,” regulation
harms efficiency by limiting the extent of competition and innovation
in the market. In the context of product quality regulations like
those applying to food and drugs, regulation may help incumbent
producers by making it more costly for newer products to enter the
market. Indeed, regulations that require producers to meet certain
minimum standards or that ban the use of certain additives may
benefit incumbent producers at the expense of producers of cheaper
substitutes. Such regulations may also harm consumers, whose needs
may be better met by these new prohibited products. The observation
that select producer interests are often among the most vocal
proponents of regulation is consistent with this regulatory capture
explanation for regulation. Indeed, as we will see, a desire to shift
the competitive playing field in favor of the producers of certain
products has historically been an important motivation for food and
drug regulation.
The fact that producer
groups are often among the most important political constituencies in
favor of regulation need not, however, imply that regulation
necessarily advances the interests of these producers at the expense
of efficiency. As noted earlier, to the extent that regulation
reduces informational asymmetries about product quality, regulation
may benefit producers of higher quality items as well as the
consumers of such goods. Indeed, such efficiency-enhancing regulation
may be particularly desirable for those producers whose goods are
least amenable to market-based solutions to the asymmetric
information problem (i.e., credence goods) precisely because it helps
these producers expand the market for their wares and increase their
profits. Hence, because it is possible for regulation that benefits
certain producers to also improve welfare, producer support for
regulation should not be taken as prima facie evidence of
Stiglerian regulation.
United States’ Experience with Food and Drug Regulation
From colonial times
until the mid to late nineteenth century, most food and drug
regulation in America was enacted at the state and local level.
Additionally, these regulations were generally targeted toward
specific food products (Hutt and Hutt 1984). For instance, in 1641
Massachusetts introduced its first food adulteration law, which
required the official inspection of beef, pork and fish; this was
followed in the 1650s with legislation that regulated the quality of
bread. Meanwhile, Virginia in the 1600s enacted laws to regulate
weights and measures for corn and to outlaw the sale of adulterated
wines.
During the latter half
of the nineteenth century, the scale and scope of state level food
regulation expanded considerably. Several factors contributed to this
growth in legislation. For instance:
Specialization and
urbanization made households more dependent on food purchased in
impersonal markets. While these forces increased the variety of
foods available, it also increased uncertainty about quality, since
the more specialized and urbanized consumers became, the less they
knew about the quality of products purchased from others (Wallis and
North 1986).
Technological
change in food manufacturing gave rise to new products and increased
product complexity. The late nineteenth century witnessed the
introduction of several new food products including alum-based
baking powders, oleomargarine (the first viable substitute for
butter), glucose, canned foods, “dressed” (i.e. refrigerated)
beef, blended whiskey, chemical preservatives, and so on (Strasser
1989; Young 1989; Goodwin 1999). Unfamiliarity with these new
products generated consumer concerns about food safety and food
adulteration. Moreover, because many of these new products directly
challenged the dominant position enjoyed by more traditional foods,
these developments also give rise to demands for regulation on the
part of traditional food producers who desired regulation to
disadvantage these new competitors (Wood 1986).
Related to the
previous point, the rise of analytic chemistry facilitated the
“cheapening” of food in ways that were difficult for consumers
to detect. For instance, the introduction of preservatives made it
possible for food manufacturers to mask food deterioration.
Additionally, the development of glucose as a cheap alternative to
sugar facilitated deception on the part of producers of high priced
products like maple syrup. Hence, concerns about adulteration were
increasingly felt. Curiously, however, the rise of analytic
chemistry also improved the ability of experts to detect these more
subtle forms of food adulteration.
Because food
adulteration became more difficult to detect, market mechanisms that
relied on the ability of consumers to detect cheating ex post
became less effective in solving the food adulteration problem.
Hence, there was a growing perception that regulation by experts was
necessary.
Given this environment,
it is perhaps unsurprising that a mixture of incentives gave rise to
food regulation in the late nineteenth century. General pure food and
dairy laws that required producers to properly label their products
to indicate whether mixtures or impurities were added were likely
enacted to help reduce asymmetric information about product quality
(Law 2003). While producers of “pure” items also played a role in
demanding these regulations, consumer groups – specifically women’s
groups and leaders of the fledgling home economics movement – were
also an important constituency in favor of regulation because they
desired better information about food ingredients (Young 1989;
Goodwin 1999). In contrast, narrow producer interest motivations seem
to have been more important in generating a demand for more specific
food regulations. For instance, state and federal oleomargarine
restrictions were clearly enacted at the behest of dairy producing
interests, who wanted to limit the availability of oleomargarine
(Dupré 1999). Additionally, state and federal meat inspection
laws were introduced to placate local butchers and local
slaughterhouses in eastern markets who desired to reduce the
competitive threat posed by the large mid-western meat packers
(Yeager 1981; Libecap 1992).
Federal regulation of
the food and drug industry was mostly piecemeal until the early
1900s. In 1848, Congress enacted the Drug Importation Act to
curb the import of adulterated medicines. The 1886 oleomargarine
tax required margarine manufacturers to stamp their product in
various ways, imposed an internal revenue tax of 2 cents per pound on
all oleomargarine produced in the United States, and levied a fee of
$600 per year on oleomargarine producers, $480 per year on
oleomargarine wholesalers, and $48 per year on oleomargarine
retailers (Lee 1973; Dupré 1999). The 1891 Meat Inspection
Act mandated the inspection of all live cattle for export as well
as for all live cattle that were to be slaughtered and the meat
exported. In 1897 the Tea Importation Act was passed which
required Customs inspection of tea imported into the United States.
Finally, in 1902 Congress enacted the Biologics Control Act to
regulate the safety of vaccinations and serums used to prevent
diseases in humans.
The 1906 Pure Food and Drugs Act and the 1906 Meat
Inspection Act
The first general pure
food and drug law at the federal level was not enacted until 1906
with the passage of the Pure Food and Drugs Act. While
interest in federal regulation arose contemporaneously with interest
in state regulation, conflict among competing interest groups
regarding the provisions of a federal law made it difficult to build
an effective political constituency in favor of federal regulation
(Anderson 1958; Young 1989; Law and Libecap 2004). The law that
emerged from this long legislative battle was similar in character to
the state pure food laws that preceded it in that its focus was on
accurate product labeling: it outlawed interstate trade in
“adulterated” and “misbranded” foods, and required producers
to indicate the presence of mixtures and/or impurities on product
labels. Unlike earlier state legislation, however, the adulteration
and misbranding provisions of this law also applied to drugs.
Additionally, drugs listed in the United States Pharmacopoeia (USP)
and the National Formulary (NF) were required to conform to USP
and NF standards. Congress enacted the Pure Food and Drug Act
along with the 1906 Meat Inspection Act, which tightened the
USDA’s oversight of meat production. This new meat inspection law
mandated ante and post mortem inspection of livestock, established
sanitary standards for slaughterhouses and processing plants, and
required continuous USDA inspection of meat processing and packaging.
While the desire to create more uniform national food regulations was
an important underlying motivation for regulation, it is noteworthy
that both of these laws were enacted following a flurry of
investigative journalism about the quality of meat and patent
medicines. Specifically, the publication of Upton Sinclair’s The
Jungle, with its vivid description of the conditions of the meat
packing industry, as well as a series of articles by Samuel
Hopkins Adams published in Collier’s Weekly about the
dangers associated with patent medicine use, played a key role in
provoking legislators to enact federal regulation of food and drugs
(Wood 1986; Young 1989; Carpenter 2001; Law and Libecap 2004).
Responsibility for
enforcing the Pure Food and Drugs Act fell to the Bureau of
Chemistry, a division within the USDA, which conducted some of the
earliest studies of food adulteration within the United States. The
Bureau of Chemistry was renamed the Food, Drug, and Insecticide
Administration in 1927. In 1931 the name was shortened to the Food
and Drug Administration (FDA). In 1940 the FDA was transferred from
the USDA to the Federal Security Agency, which, in 1953, was renamed
the Department of Health, Education and Welfare.
Whether the 1906 Pure
Food and Drugs Act was enacted to advance special interests or to
improve efficiency is a subject of some debate. Kolko (1967), for
instance, suggests that the law reflected regulatory capture by
large, national food manufacturers, who wanted to use federal
legislation to disadvantage smaller, local firms. Coppin and High
(1999) argue that rent-seeking on the part of bureaucrats within the
government – specifically, Dr. Harvey Wiley, chief of the Bureau of
Chemistry – was a critical factor in the emergence of this law.
According to Coppin and High, Wiley was a “bureaucratic
entrepreneur” who sought to ensure the future of his agency. By
building ties with pro-regulation interest groups and lobbying in
favor of a federal food and drug law, Wiley secured a lasting policy
area for his organization. Law and Libecap (2004) argue that a
mixture of bureaucratic, producer and consumer interests were in
favor of federal food and drugs regulation, but that the last-minute
onset of consumer interest in regulation (provoked by muckraking
journalism about food and drug quality) played a key role in
influencing the timing of regulation.
Enforcement of the Pure
Food and Drugs Act met with mixed success. Indeed, the evidence
from the enforcement of this law suggests that neither the pure
industry capture nor public interest hypotheses provide an adequate
account for regulation. On the one hand, some evidence suggests that
the fledgling FDA’s enforcement work helped raise standards and
reduce informational asymmetries about food quality. For instance,
under the Net Weight Amendment of 1919, food and drug packages
shipped in interstate commerce were required to be “plainly and
conspicuously marked to show the quantity of contents in terms of
weight, measure, and numerical count” (Weber 1928, p. 28).
Similarly, under the Seafood Amendment of 1934, Gulf coast
shrimp packaged under FDA supervision was required to be stamped with
a label stating “Production supervised by the U.S. Food and Drug
Administration” as a mechanism for ensuring quality and freshness.
Additionally, during this period, investigators from the FDA played a
key role in helping manufacturers improve the quality and reliability
of processed foods, poultry products, food colorings, and canned
items (Robinson 1900; Young 1992; Law 2003). On the other hand, the
FDA’s efforts to regulate the patent medicine industry –
specifically, to regulate the therapeutic claims that patent medicine
firms made about their products – were largely unsuccessful. In
U.S. vs. Johnson (1911), the Supreme Court ruled that
therapeutic claims were essentially subjective and hence beyond the
reach of this law. This situation was partially alleviated by the
Sherley Amendment of 1912, which made it possible for the
government to prosecute patent medicine producers who intended to
defraud consumers. Effective regulation of pharmaceuticals was
generally not possible, however, because under this amendment the
government needed to prove fraud in order to successfully prosecute a
patent medicine firm for making false therapeutic claims about its
products (Young 1967). Hence, until new legislation was enacted in
1938, the patent medicine industry continued to escape effective
federal control.
The 1938 Food, Drugs and Cosmetics Act
Like the law it
replaced (the 1906 Pure Food and Drugs Act), the Food,
Drugs and Cosmetics Act of 1938 was enacted following a
protracted legislative battle. In the early 1930s, the FDA and its
Congressional supporters began to lobby in favor of replacing the
Pure Food and Drugs Act with stronger legislation that would
give the agency greater authority to regulate the patent medicine
industry. These efforts were successfully challenged by the patent
medicine industry and its Congressional allies until 1938, when the
so-called “Elixir Sulfanilamide tragedy” made it impossible for
Congress to continue to ignore demands for tighter regulation. The
story behind the Elixir Sulfanilamide tragedy is as follows. In 1937,
Massengill, a Tennessee drug company, began to market a liquid sulfa
drug called Elixir Sulfanilamide. Unfortunately, the solvent in this
drug was a highly toxic variant of antifreeze; as a result, over 100
people died from taking this drug. Public outcry over this tragedy
was critical in breaking the Congressional deadlock over tighter
regulation (Young 1967; Jackson 1970; Carpenter and Sin 2002).
Under the 1938 law, the
FDA was given considerably greater authority over the food and drug
industry. The FDA was granted the power to regulate the therapeutic
claims drug manufacturers printed on their product labels; authority
over drug advertising, however, rested with the Federal Trade
Commission (FTC) under the Wheeler-Lea Act of 1938.
Additionally, the new law required that drugs be marketed with
adequate directions for safe use, and FDA authority was extended to
include medical devices and cosmetics. Perhaps the most striking and
novel feature of the 1938 law was that it introduced mandatory
pre-market approval for new drugs. Under this new law, drug
manufacturers were required to demonstrate to the FDA that a new drug
was safe before it could be released to the market. This
feature of the legislation was clearly a reaction to the Elixir
Sulfanilamide incident; food and drug bills introduced in Congress
prior to 1938 did not include provisions requiring mandatory
pre-market approval of new drugs.
Within a short period
of time, the FDA began to deem some drugs to be so dangerous that no
adequate directions could be written for direct use by patients. As a
consequence, the FDA created a new class of drugs which would only be
available with a physician’s prescription. Ambiguity over whether
certain medicines – specifically, amphetamines and barbiturates –
could be safely marketed directly to consumers or required a
physician’s prescription led to disagreements between physicians,
pharmacists, drug companies, and the FDA (Temin 1980). The political
response to these conflicts was the Humphrey-Durham Amendment
in 1951, which permitted a drug to be sold directly to patients
“unless, because of its toxicity or other potential for harmful
effect or because the method of collateral measures necessary to its
use, it may safely be sold and used only under the supervision of a
practitioner.”
The most significant
expansion in FDA authority over drugs in the post World War II period
occurred when Congress enacted the 1962 Drug Amendments (also
known as the Kefauver-Harris Amendments) to the Food, Drugs and
Cosmetics Act. Like the 1938 law, the 1962 Drug Amendments
were passed in response to a therapeutic crisis – in this instance,
the discovery that the use of thalidomide (a sedative that was
marketed to combat the symptoms associated with morning sickness) by
pregnant women caused birth deformities in thousands of babies in
Europe.
As a result of these amendments, drug companies were required to
establish that drugs were both safe and effective prior to
market release (the 1938 law only required proof of safety) and the
FDA was granted greater authority to oversee clinical trials for new
drugs. Under the 1962 Drug Amendments, responsibility for
regulating prescription drug advertising was transferred from the FTC
to the FDA; furthermore, the FDA was given the authority to establish
good manufacturing practices in the drug industry and the power to
access company records to monitor these practices. As a result of
these amendments, the United States today has among the toughest drug
approval regimes in the developed world.
A large and growing
body of scholarship has been devoted to analyzing the economics and
politics of the drug approval process. Early work has focused on the
extent to which the FDA’s pre-market approval process has affected
the rate of innovation and the availability of new pharmaceuticals.
Peltzman (1973), among others, argues that 1962 Drug Amendments
significantly reduced the flow of new drugs onto the market and
imposed large welfare losses on society. These views have been
challenged by Temin (1980) who maintains that much of the decline in
new drug introductions occurred prior to the 1962 Drug Amendments.
More recent work, however, suggests that the FDA’s pre-market
approval process has indeed reduced the availability of new medicines
(Wiggins 1981). In international comparisons, scholars have also
found that new medicines generally become available more quickly in
Europe than in America, suggesting that tighter regulation in the
U.S. has induced a drug-lag (Wardell and Lasagna 1975; Grabowsky and
Vernon 1983; Kaitin and Brown 1995). Some critics believe that the
costs of this drug lag are large relative to the benefits because
delay in the introduction of new drugs prevents patients from
accessing new and more effective medicines. Gieringer (1985), for
instance, estimates that the number of deaths that can be attributed
to the drug lag far exceeds the number of lives saved by extra
caution on the part of the FDA. Hence, according to these authors,
the 1962 Drug Amendments may have had adverse consequences for
overall welfare.
Other scholarship has
examined the pattern of drug approval times in the post 1962 period.
It is commonly observed that larger pharmaceutical firms receive
faster drug approvals than smaller firms. One interpretation of this
fact is that larger firms have “captured” the drug approval
process and use the process to disadvantage their smaller
competitors. Empirical work by Olson (1997) and Carpenter (2002),
however, casts some doubt on this Stiglerian interpretation.
These authors find that while larger firms do generally receive
quicker drug approvals, drug approval times are also responsive to
several other factors, including the specific disease at which a drug
is directed, the number of applications submitted by the drug
company, and the existence of a disease-specific interest group.
Indeed, in other work, Carpenter (2004a) demonstrates that a
regulator that seeks to maximize its reputation for protecting
consumer safety may approve new drugs in ways that appear to benefit
large firms.
Hence, the fact that large pharmaceutical firms obtain faster drug
approvals than small firms need not imply that the FDA has been
“captured” by these corporations.
Food and Drug Regulation since the 1960s
Since the passage of
the 1962 Drug Amendments, federal food and drug regulation in the
United States has evolved along several lines. In some cases,
regulation has strengthened the government’s authority over various
aspects of the food and drug trade. For instance, the 1976 Medical
Device Amendments required medical device manufacturers to
register with the FDA and to follow quality control guideline. These
amendments also established pre-market approval guidelines for
medical devices. Along similar lines, the 1990 Nutrition Labeling
and Education Act required all packaged foods to contain
standardized nutritional information and standardized information on
serving sizes.
In other cases,
regulations have been enacted to streamline the pre-market approval
process for new drugs. Concerns that mandatory pre-market approval of
new drugs may have reduced the rate at which new pharmaceuticals
become available to consumers prompted the FDA to issue new rules in
1991 to accelerate the review of drugs for life-threatening diseases.
Similar concerns also motivated Congress to enact the Prescription
Drug User Fee Act of 1992 which required drug manufacturers to
pay fees to the FDA to review drug approval applications and required
the FDA to use these fees to pay for more reviewers to assess these
new drug applications.
Speedier drug approval times have not, however, come without costs.
Evidence presented by Olson (2002) suggests that faster drug approval
times have also contributed to a higher incidence of adverse drug
reactions from new pharmaceuticals.
Finally, in a few
instances, legislation has weakened government’s authority over
food and drug products. For example, the 1976 Vitamins and
Minerals Amendments precluded the FDA from establishing standards
that limited the potency of vitamins and minerals added to foods.
Similarly, the 1994 Dietary Supplements and Nutritional Labeling
Act weakened the FDA’s ability to regulate dietary supplements
by classifying them as foods rather than drugs. In these cases, the
consumers and producers of “natural” or “herbal” remedies
played a key role in pushing Congress to limit the FDA’s authority.
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