The U.S. may well be on the verge of a major shift in how drugs are marketed—the most significant shift since direct-to-consumer advertising began.

The Wall Street Journal reported Thursday how drug companies are “mounting a legal campaign to overturn longstanding U.S. regulations prohibiting them from pitching medicines for uses not listed on the bottle.” This would be a major change because such off-label marketing has been the basis of multibillion-dollar legal settlements involving drug companies in recent years. 

The most recent example of such penalties came Thursday when GlaxoSmithKline announced that it would pay $3 billion (a record) to settle civil and criminal suits involving off-label marketing, among other allegations.

(As an aside, ProPublica reported in September how the government did not seek to charge or otherwise sanction physicians named in lawsuits against the drug companies, focusing on the firms themselves.)

The New York Times also had an interesting story about the pharmaceutical industry Thursday, focused on conflicts of interest among the panelists who are writing guidelines for proper use of drugs to treat hypertension, cholesterol and obesity.

“Consciously or not, they may well be making decisions that fit their funders, their payers and not the patient’s best interests,” said David J. Rothman, president of the Institute on Medicine as a Profession, a nonprofit center affiliated with Columbia University, told The times. “If you want the public to really believe in the guidelines, why not have a committee that is conflict-free?”

Others defended such conflicts, saying panelists with ties to companies had to disclose them and recuse themselves from certain votes. Dr. Neil J. Stone of Northwestern University, chairman of the cholesterol panel, told The Times, “We’re taking extraordinary measures to reduce any bias from potential conflicts of interest on a panel with tremendous expertise.”