...Some drug industry critics are not so surprised that advertising oversight has slackened. "The question is whether the industry has gotten better at complying with the rules or the FDA has gotten worse at enforcing them. It's probably a combination of the two," says Shannon Brownlee, author of the new book Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer...

The book describes how the industry fought the FDA to loosen ad restrictions on the basis of free speech, taking the battle all the way to the Supreme Court, and has since exploited the agency's rather lax rules to exert an unprecedented amount of marketing muscle. "The FDA has been beaten down by the drug industry," Brownlee says. And to great effect: Every dollar the drug industry spends on DTC advertising generates $4.20 in increased sales, Brownlee writes, outpacing the return of even the fast-food industry, which spends a similar amount on consumer advertising. Will those seeking to muzzle drug ads just give up? Don't count on it. Says study co-author Donohue, "As long as direct-to-consumer [advertising] is around and there are concerns about drug safety, there will be efforts to restrict it..."

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