Every week there seems to be a new gauntlet for pharma PROs to run, from product scandals to the interrogation of the Health Select Committee.
Having sat through a session of the latter, in which Ogilvy Healthworld's Margot James provided such a valiant defence, I feared the worst for the PR industry, envisaging a coming straight-jacket of restrictions on promotion.
However, PR got off relatively lightly, and the recommendations in terms of regulation are not thought likely to have a significant impact.
But just when PROs might think it safe to come out of the woods, a new reputation management challenge rears its ugly head - in the form of a sure-fire box office hit, at cinemas near you from 11 November. The Constant Gardener, a film based on John Le Carre's angry indictment of the pharma industry and featuring Ralph Fiennes and Rachel Weisz, opened to rave reviews in the US. Set mostly in Kenya, it follows a British diplomat as he investigates the murder of his wife, to find she was compiling data on a multinational drugs company that uses Africans as guinea pigs for a TB remedy with dangerous side effects.
Okay, it is just a populist thriller, but the film doesn't pull its punches.
The trailer features the line: 'Pharmaceutical companies are right up there with arms dealers.' And despite the fantasy, groups on the internet are trading conspiracy theories and drawing comparisons with real-life clinical trials, spinning off into more general condemnation of the ethics of pharmas. The word Vioxx makes a frequent appearance.
Moreover, Le Carre claims to have used experience gained as a spy to research the story, and at the end of the book writes: 'As my journey through the pharmaceutical jungle progressed, I came to realise that, by comparison with reality, my story was as tame as a hospital postcard.'
The Constant Gardener is unlikely to cause the kind of stir generated by the making of Michael Moore's Sicko in 2004, when six pharmas notified staff that they faced potential ambush and all communications should be handled through PROs.
But what we are seeing is a building consensus that pharmas are not on the side of the angels, a perception that is becoming part of our popular culture and likely to create more challenges than anything the Select Committee could dream up.