FDA Commissioner Marty Makary unveiled a pilot to offer bonus payments to reviewers who complete drug reviews ahead of schedule, with the first quarterly payments slated for around August. The agency framed the program as a tool to recognize efficiency while committing that speed would not replace quality; payments would be tied to weighted time savings and quality metrics. The proposal prompted immediate questions about distribution across multi‑person review teams and potential ethical tensions if incentives are perceived to reward haste over thorough evaluation. The pilot arrives amid broader staffing losses and regulatory shifts at FDA and will be closely watched by industry and patient advocates for effects on review integrity and timelines.