Yet despite this history, recently courts have undermined the FDA’s authority to require that a drug demonstrate safety and efficacy for each use in advance of marketing. In 2 decisions, Sorrell v IMS Health4 and United States v Caronia,5 federal courts have suggested that the FDA’s authority is at odds with a new and expansive notion of the First Amendment’s protection of commercial speech. Under this view, companies have a right to engage in marketing, and requiring a government agency to review the information beforehand is “paternalistic” and an impermissible effort to censor a particular viewpoint. The courts suggested that less speech-restrictive options are available, such as educating physicians to distinguish between misleading statements and those backed by evidence. As a matter of legal precedent, these 2 decisions were narrower than might appear, but they left ample room for expansion as well.