If events over the past few years are any indication, it may well be that the future of pharmacotherapy is played out as much in the courts and in the halls of government as it is in physicians' offices, hospital rooms or research laboratories. At the Patented Medicines Pricing Review Board symposium held at the end of 2002 in Ottawa, Canada, Mr Tim Caulfield from the Health Law Institute, Edmonton, Canada, painted a complex, and sometimes less than attractive, picture of the future of pharmacotherapy.