In sum, Knoll sponsored a research study and, when it found the conclusions to not be to its taste, embarked upon a campaign of scientific distortion and legal threats. Six years after the studys completion, and over one year since it passed peer review in a prestigious medical journal, the investigators manuscript has still not been published, and, due to Knolls publication of its own self-serving article, may now not be publishable. These events would not have occurred had the FDA adequately regulated levothyroxine and provided adequate guidelines on bioequivalence determination. The FDA has essentially permitted the pharmaceutical industry to regulate itself in this area, with predictable consequences. However, the suppression of these findings, which have enormous implications for the practice of clinical medicine and cost-containment, would not have occurred had UCSF not failed to review the contract and then succumbed to the gag clause, thereby sounding a retreat from the time-honored principle of academic freedom. The public has been ill-served by both of these institutions.