"It ain't pretty," as the private detectives say in pulp fiction. Of course, Pharmaceutical Executive's Agency Confidential investigates healthcare advertising not crime scenes. And so far we haven't tripped over any corpses. What we have found while snooping around the industry's top agencies are a set of some pretty dim stats. Consider:

• Explosive growth rate of healthcare advertising and marketing seen in 2006 has slowed.
• Healthcare spending rates in 2008 were well below the total industry average.
• Consumer advertising for prescription drugs was down 8 percent in 2008 (the first reduction in DTC spending since the late 1990s). And a further 11 percent reduction is expected in 2009.
• Drugmakers are cutting expenses across the board, including the number of sales reps.
• Manufacturers are also seeing Rx sales slow as more consumers decide not to fill scripts and/or move to generics.
• Brand advertising is an easy target for cost-cutting.
• Sales are hurting as food trumps meds.