Makary’s out at FDA, Sanofi’s priority voucher issues, top exec pay

Moments after recording this episode of The Weekly, FDA Commissioner Marty Makary announced his resignation. Reports first circulated last Friday that President Donald Trump had signed off on his ouster. The president initially denied this account, originally from The Wall Street Journal, on Saturday morning, but appears to have now confirmed the plan.

This confusion underscores a key theme in Robert F. Kennedy Jr.’s health department: lack of transparency and clear communication. Makary’s exit also highlights the high level of senior leadership turnover across the Department of Health and Human Services. With Makary is on his way out, the FDA will reportedly be helmed by an acting commissioner, Kyle Diamantas. This would also be fitting for an agency whose two key review divisions—the Center for Biologics Evaluation and Research (CBER) and Center for Drug Evaluation and Research (CDER)—are currently led by temporary directors.

Meanwhile, one of Makary’s key initiatives, the Commissioner’s National Priority Review (CNPV) program, hit a snag last week as Sanofi has reportedly requested that the FDA remove its diabetes prevention drug Tzield from the scheme. This comes after acting CDER director Tracy Beth Høeg apparently intervened in the drug’s review.

And in the business realm, BioSpace kicks off our annual compensation report. Who made the most money in 2025? Was it Eli Lilly’s David Ricks or Johnson & Johnson’s Joaquin Duato? Read BioPharm Executive to find out. Not subscribed? Sign up here for all of BioSpace’s insightful newsletters.