Bias-free health care

Bravo to Dr Biron et al¹ and to Drs Steinman and Baron,² in the Commentary and Debates sections respectively, for bringing our attention to the pervasive and negative effects of the influence of the pharmaceutical industry on continuing medical education. I am disappointed that Dr Marlow³ would use the guidelines in place as an argument that safeguards against undue influence are preventing this problem. One only has to attend a large continuing medical education conference (such as a Chapter meeting) and feel overwhelmed by the numerous booths hosted by pharmaceutical representatives to realize that something is wrong with the situation. We obviously are not being protected from undue influence by said guidelines.

I would also like to bring attention to another troubling issue—clear overpricing of many new drugs, such as monoclonal antibodies, which are proving useful against many cancers. When a drug such as rituximab costs $3000 per treatment, it clearly is out of reach for most of our patients. This creates a 2-tiered system when governments will not fund this drug. Clearly, profit is taking precedence over optimal care. The pharmaceutical industry must take responsibility for creating such a situation, and, clearly, governments need to address the regulation of drug pricing.