The article analyzes the course of the US Food and Drug Administration (FDA) after the departure of Vinay Prasad, which focused on stricter drug review. It focuses on six drug makers over six months in the post-Prasad era. It examines whether FDA regulatory policies will change, particularly for drugs for rare diseases. In 2023, the FDA approved 55 new drugs, of which more than half (28, i.e. 51%) were designated for rare diseases with the orphan drug designation. Among the approved drugs are, for example, Qalsody for amyotrophic lateral sclerosis (ALS) with SOD1 gene mutation, Joenja for activated phosphoinositide 3-kinase delta syndrome and Sohonos for fibrodysplasia ossificans progressiva. 65% of approvals (36 out of 55) used accelerated programs such as Fast Track or Accelerated Approval. The article charts how the FDA is dealing with Prasad's absence in regulating these drugs.