Are you saying a completely free market for drugs would be a good thing?

An NDA requires peer-reviewed studies, and something that looks at least a little like scientific rigour.

Of course we could just not bother with that.

Is that really a smart thing to do?

Require phase 1 only. That proves safety, but not efficacy. Require the companies to publicly release all data from their evaluations to the public. It's my right to decide on the risk / reward tradeoff, not some worthless bureaucrat to decide for me.