“Imagine planning your day around your life, instead of your osteoarthritis pain,” enticed Merck’s advertising campaign for Vioxx, its blockbuster arthritis drug. The drug Merck promoted “for everyday victories” soon became a symbol of regulatory failure as evidence emerged linking Vioxx with serious cardiovascular side effects and deaths. At the beginning of Senate hearings convened in 2004 to investigate Vioxx’s withdrawal from the market, Senator Charles Grassley (R-IA) alleged that the FDA had “allowed itself to be manipulated by Merck” and, more broadly, that “the FDA has a relationship with drug companies that is far too cozy.” The remedy for coziness with industry and for regulatory failure, Senator Grassley continued, would include “changes inside the FDA that [would] result in greater transparency and greater openness.” In its 2007 review of American drug safety, the Institute of Medicine (IOM) similarly claimed, “the FDA’s reputation has been hurt by a perceived lack of transparency and accountability to the public.” As part of its package of proposals to improve the agency’s impaired reputation, the Institute of Medicine called on the FDA to make greater use of its public advisory committees – groups of nongovernmental medical practitioners, researchers, and stakeholder representatives that the FDA consults on matters such as drug approval and labeling – to supplement agency expertise and to enhance transparency in the drug approval process. These proposals suggested public engagement could render FDA decisions both more accountable and less prone to regulatory failure.