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Pharmacy law experts have cast the system as a perversion of medical regulations that allowed nearly anyone with a credit card to order steroidsand other drugs. Many doctors did not even prescribe them. Instead they sent out the prescriptions directly to drug companies, which did more work and had higher profit margins. Pharmaceutical executives testified on the subject before the Senate Commerce Committee and said that doctors' greed drove up prescriptions, but some studies show no relationship. Critics also say that the system has a strong incentive for doctors to overbook. If a patient isn't able to get a prescription immediately, they are put off by the long wait and may switch to another doctor. "Patients are being put in danger by the short supply of medications," said Nancy Klimas, a health-care consultant in Virginia and author of the new book "The Pharmacy Revolution," which lays out the case for the reform now that the rules are in effect. The rules come at a time when prescription drug costs are rising at the fastest rate yet and are more than twice as high as in 2003, when they peaked before declining and then beginning to rise again. Over the past decade, annual average costs for brand-name drugs, including brand-name versions of drugs that aren't prescription drugs, has risen more than 50%, according to government data. That is more than double the cost rate of inflation, and it has accelerated since 2003, when annual average cost was $25 a month. There is concern about the lack of competition in the market because of patents on brand-name drugs. For example, when Valeant Pharmaceuticals bought the rights to Lipitor, it had already won two other pharmaceutical patents on the drugs, which were no longer generic options. "We are losing the race to the bottom," said Kevin McNamee, associate professor of health care policy at Vanderbilt University School of Medicine. "Patents, they matter for the drug corporations because they provide them with an effective monopoly in the marketplace." The FDA regulates drugs by taking into account the safety and efficacy of the drug, its dosage and whether a specific diagnosis applies to the patient. The agency conducts tests to look for the safety and efficacy of medical devices. It sets minimum dosage levels for drugs and regulates the accuracy of drugs' labeling. The FDA says that it has a "best practices" program that promotes more transparency between manufacturers and the public, but critics say the agency's regulations are weakened to make them easier to follow. Some doctors, for example, said that they would hesitate to prescribe a drug for a particular disease if they had never seen it before because they didn't see the Related Article: