The biotech industry wrote Montana's right-to-try law. Now they're running the show.

Investors on the libertarian fringe of the biotech industry are making their dream of wide-ranging access to experimental drugs a reality in Montana.

Last year, they helped draft a state law to expand access to drugs that no regulator has deemed safe and effective. Now, Montana is relying on a privately run board to decide which treatments to offer — raising concerns about conflicts of interest and, in an industry rife with unfounded claims, whether patients will get value for their money.

A company that works with biotech firms in a regulation-free zone off the coast of Honduras is in charge. Last month, the board authorized its first treatment: Patients seeking a cure for hearing loss will take a daily antihistamine and listen to a Denver company's proprietary sound mix for 60 minutes a day.

The treatment hasn't been cleared by the Food and Drug Administration, and it wasn't reviewed by the state. It was approved by a privately run review board created by a biotech investor named Niklas Anzinger.

Anzinger is a key figure in Próspera, a private city on a Caribbean island, where anti-aging startups can administer experimental treatments without government oversight or evidence that they are safe.

Próspera, whose investors include Peter Thiel and Marc Andreessen, gained attention last year when longevity influencer Bryan Johnson was filmed receiving a $25,000 gene therapy treatment there in the widely watched Netflix documentary, "Don't Die."

Now, players in the booming global longevity industry want to make Montana into a similar medical tourism hub.

More than 40 US states have adopted measures designed to increase patients' access to therapies not approved by the FDA, and two federal programs also allow some patients to access unapproved treatments.

Montana's "right-to-try" law allows a much broader swath of patients, including those who don't have life-threatening illnesses, to access experimental treatments.

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Anzinger argues that small biotechs can't compete in a market regulated through large, expensive clinical trials and that they need a system like Montana's to finance and develop therapies that patients would otherwise never get. He says that Montana's system will cut costs and provide a top-tier clinical space for Americans who now travel abroad for everything from psychedelic drugs in Mexico to cutting-edge hair replacement in Turkey and stem cells in Switzerland.

"This is really kind of a potential paradigm change in how we do science instead of top down, more bottom up, but still in a controlled way with oversight and everything," Anzinger said on a recent podcast.