Institutionalizing Misinformation: The Dietary Supplement Listing Act of 2022

From the New England Journal of Medicine

By Pieter A. Cohen, MD; Jerry Avorn, MD; Aaron S. Kesselheim, MD, JD, MPH

SUMMARY: This NEJM Perspective critically evaluates the Dietary Supplement Listing Act of 2022, arguing that the bill would create an appearance of regulatory reform while leaving the core problems of supplement oversight unresolved. The authors — Cohen, Avorn, and Kesselheim — contend that the Act's listing requirement would be largely symbolic, providing regulators and consumers with an illusion of oversight without granting the FDA meaningful enforcement authority over supplement safety or efficacy claims. The current regulatory framework for dietary supplements, established by the 1994 Dietary Supplement Health and Education Act, is already widely regarded as lax; the 2022 bill, the authors argue, would institutionalize this inadequacy under a veneer of reform, potentially making genuine future reform harder to achieve.

BACKGROUND: The Dietary Supplement Health and Education Act of 1994 established a regulatory framework widely criticized as insufficient to protect consumers. The Dietary Supplement Listing Act of 2022 was proposed as a reform measure.

KEY FINDINGS: The 2022 bill would create only the impression of reform while leaving the current lax regulatory framework largely untouched. A listing requirement alone does not grant the FDA meaningful enforcement authority over supplement safety or efficacy.

IMPLICATIONS: The bill risks institutionalizing inadequate oversight under a veneer of reform, potentially impeding future genuine regulatory improvement for the dietary supplement industry.