In the late 1950s, the late Democratic Senator Estes Kefauver, Chairman of the United States Senate's Anti-Trust and Monopoly Subcommittee, put together the first extensive indictment against the business workings of the pharmaceutical industry.

Despite the potential for conflict of interest, virtually all practicing physicians in the U.S. have some form of relationship with pharmaceutical manufacturers but the nature and extent of those relationships vary, depending on the kind of practice, medical specialty, patient mix, and professional activities, reports a study in the April 26 issue of the New England Journal of Medicine.

In 2002 the European parliament voted resoundingly against allowing drug companies to provide information about their products directly to patients. However, five years on, this decision is set to be challenged again.