Last month, President Biden finally nominated a permanent commissioner to lead the Food and Drug Administration, after leaving the position vacant since taking office. Robert M. Califf, a respected cardiologist and clinical trial specialist, has now faced a grilling from lawmakers as he seeks Senate approval.

Patients will want to know his answer to one question above all: How quickly should the FDA approve new drugs?

Of course, the easy answer is that effective drugs should be approved as quickly and safely as possible. But how to achieve that goal is a subject of much debate.

As the regulator responsible for the safety of food and medical products, the FDA wields enormous influence over our health. Typically, drugs go through years of trials to test effectiveness and safety, after which the agency aims to complete review within 10 months. But the FDA has rules that let it accelerate this process for drugs targeting serious conditions that lack good treatment alternatives.

Whether a new medicine gets accelerated approval can make an enormous difference to patients, especially those with rare and thus-far untreatable conditions. It can mean the difference between hope and desperation for families.

The FDA typically only grants accelerated approval for drugs combating life-threatening diseases. These are the cases where patients and families feel the most urgent need for treatment. A few cases from this year include Amgen's Lumakras for metastatic lung cancer, Regeneron's Libtayo for advanced basal cell carcinoma, and ADC Therapeutics' Zynlonta for large B-cell lymphoma.

But whether a review is expedited and an accelerated approval is granted for certain cutting-edge drugs often comes down to who's at the helm of the FDA.

Luckily, we have a pretty good idea of where Califf stands on accelerated approval -- because he already served as FDA commissioner during the last year of the Obama administration. After that term ended, Califf told a JAMA podcast that "patient groups have been very clear that they are willing to take a high degree of risk to have earlier access." His words suggest an openness to listening to patient needs.

Moreover, Califf headed the agency when it approved a drug to treat a rare and fatal disease, Duchenne muscular dystrophy.

Young patients and their parents had pushed hard for quick approval of the drug, Eteplirsen. But though study results were promising, some experts deemed the trials too small to warrant approval. Despite the ensuing controversy, the agency ultimately made the right call, granting accelerated approval on the condition that the developer conducts another trial.

In many of his decisions, Califf has shown interest in using evidence from beyond the traditional trial process, for example, by taking into account case studies, patient experiences, and electronic health data when making regulatory calls. He understands that such new approaches contribute to -- rather than detract from -- scientific rigor.

Califf has a history of protecting U.S. health in other ways, too. He's a strong advocate for tobacco control, especially with regard to minors, and during his previous stint at the FDA, pushed for robust package-label warnings against mixing opioids and benzodiazepines, which can be deadly.

Right now, patients suffering from diseases with no known treatment want to know if Califf will move fast enough to save lives. The answer is, most likely, yes. Even better, he has decades of real-world trial experience behind him, and a vision of the future. Biden made the right choice to lead the agency as we emerge from a pandemic and tackle the health challenges ahead.

Peter J. Pitts, a former FDA Associate Commissioner and member of the United States Senior Executive Service, is President of the Center for Medicine in the Public Interest and a Visiting Professor of Medicine at the University of Paris Medical School