Studies of US Department of Health and Human Services Agency Advisory Committees

Importance Federal advisory committees provide external expertise and public input to inform regulatory and policy decision-making across agencies within the US Department of Health and Human Services (HHS). Concerns persist about their use, composition, conflicts of interest (COIs), deliberation, transparency, and influence on agency decisions. Objective To identify and characterize original research studies evaluating the implementation and impact of advisory committees convened by HHS agencies since enactment of the Federal Advisory Committee Act. Evidence Review MEDLINE, Embase, Scopus, HeinOnline, EconLit, SSRN, the National Bureau of Economic Research, the HHS Office of Inspector General, the Government Accountability Office, and Google were searched for English-language original studies published from October 6, 1972, through April 10, 2025. Eligible studies characterized the implementation and impact of advisory committees advising agencies within HHS. Studies were categorized by agency and topic domains: meeting use and management, composition, deliberation content and voting, and regulatory impact and performance. Findings within each topic domain were extracted. Findings Among 146 included studies published between 1974 and 2025, 91 (62.3%) were peer-reviewed research articles and 55 (37.7%) were non–peer-reviewed studies. Most studies examined advisory committees convened by the Food and Drug Administration (FDA; 132 studies [90.4%]), with fewer studies focusing on those convened by the Centers for Disease Control and Prevention (5 studies [3.4%]), National Institutes of Health (5 studies [3.4%]), and Centers for Medicare & Medicaid Services (2 studies [1.4%]). Meeting use and management was the most commonly examined topic domain (98 studies [67.1%]). Five of the 13 secondary topic domains (38.5%) included only FDA studies, and no secondary topic domain included more than 2 studies (1.4%) on any single non-FDA HHS agency. Key findings included continued use of FDA advisory committees over time despite wide variation across product types and a decline after 2010, a recent increase in FDA advisory committee members’ COIs after a substantial decline following the FDA Amendments Act, and generally high concordance between advisory committee recommendations and agency decisions. Conclusions and Relevance In this systematic review of original research studies, evidence on HHS advisory committees was concentrated largely on those convened by FDA. Variation in advisory committee use and management, ongoing COI concerns, and limited evidence on advisory committees convened by HHS agencies other than FDA suggest opportunities for reform and the need for more studies evaluating advisory committee implementation and impact across HHS.