Indeed very interesting. I think realistically, the choice is between 4 and 5 (see table on page 116).
Combining option 4 (more transparency with open access to trial data) with a renewal policy that would require drug makers to reapply every five years could make a huge difference. If I understand it correctly, that is what the European policy will be after Jan 1, 2014.
I would also make sure that independent groups have more voice in the approval/re-approval process.
Option 5 (independent entities conducting the clinical trials) may work even better but it is a long-term fight.
We also need personal liabilities for fraud as the fines are not working.
- Eva