Healthcare leaders want drug company payments to doctors made public

A group of Canadian healthcare leaders wants pharmaceutical companies to have to disclose how and why they pay people who prescribe their drugs, saying it would show potential bias and help build trust.

Seventeen people signed an open letter sent to Health Minister Jane Philpott this week, saying Canada should follow the lead of countries such as France, Denmark and the United States, which require pharmaceutical companies tell the government about payments to prescribers as small as $10 US.

Dr. Chris Simpson, vice-dean of the Queen’s University medical school in Kingston, Ont., and signee of the letter, said these companies can pitch their products to doctors by hosting them for a lunch and giving a talk about a drug or giving them free samples for patients who couldn’t otherwise afford them.

“I think it’s important to point out these payments aren’t nefarious or bad, it’s just that when payments are made from a drug company to a prescriber who may be prescribing drugs made by that company, that there may be biases introduced,” he said.

“These biases may not even be bad, they just need to be recognized and put into context.”

Simpson said the stakes are especially high when guidelines are being set for a new drug.

“When panels of experts are evaluating the evidence and making a recommendation, those recommendations tend to carry a lot of weight in the medical community,” he said.

“So it’s important to know precisely how those experts may have been influenced or what their biases may be.”

Pitched as a small change to rules

The letter, part of the Open Pharma campaign to make Canada’s healthcare system more transparent, says making it mandatory for pharmaceutical companies to share this kind of information would only take a tweak of Canada’s medical patent rules and would increase confidence in the healthcare system.

“This whole thing is really dependent on a therapeutic relationship built on trust, and trust comes following transparency,” Simpson said.

“I think the average patient following a change like this would be able to have increased confidence that expert guidelines are written by people whose potential conflicts and biases are clearly declared and contextualized.”

Philpott’s office said Friday it recieved the proposal this week and is looking into if and how it would work.

“We remain open to new approaches to increase transparency for Canadians, and will look into the recommendations to better understand them,” said a spokesperson in a statement.

Canadian patented medicine pricing is already under review by her office, with the goal of making prescription drugs less expensive.

Some data voluntarily released

Ontario’s health minister is considering his own changes to transparency rules, with no timeline yet for a decision.

“Our government is focused on our own consultations which are currently underway to assess whether additional measures are needed to increase transparency in health care by publicly disclosing payments by the medical industry to health care providers,” said a spokesperson for Dr. Eric Hoskins.

Ten Canadian pharmaceutical companies released financial data in June, but it was criticized by Open Pharma for not including names or reasons.

The data did show most of these companies spent multiple millions of dollars to health care professionals over either a year-long or six-month window.

Innovative Medicines Canada, which represents about 50 pharmaceutical companies, has not responded to a request for comment on the issues raised in the letter.

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