How to Prevent a Year of Death and Suffering for 84 Cents

By allocating $21.8B/year to a decentralized FDA, automating efficacy testing through pragmatic clinical trials integrated into standard healthcare, this clears the 443 years (95% CI: 324 years-712 years) treatment testing backlog in 36 years (95% CI: 11.6 years-77.2 years), delivering 637:1 (95% CI: 569:1-790:1) ROI, saving 10.7B deaths (95% CI: 7.39B deaths-16.2B deaths), and generating $58.6B (95% CI: $49.2B-$73.1B) in annual R&D savings at $0.841 (95% CI: $0.242-$1.75)/DALY (97.7% (95% CI: 97.5%-98.9%) cost reduction, 12.3x (95% CI: 4.19x-61.3x) capacity increase).