Social Policy in Ontario

The opioid crisis in Canada is getting worse, despite efforts to curtail it. The latest figures suggest that more than 4,000 Canadians died last year from opioid overdoses.

The main culprit for all this death currently is illicit fentanyl, which is 100 times more toxic than morphine. But the root cause of much of this crisis is OxyContin, which was prescribed widely by doctors before it was fully understood just how addictive and subject to abuse it could be.

In that context, it’s disquieting to know that Purdue Pharma, the maker of OxyContin paid Canadian doctors $2 million in 2016 for services rendered.

And, according to reporting by the Star’s Jesse McLean, that means the drug manufacturer paid Canadian doctors three times the amount it paid American doctors on a per capita basis.

Why might that be?

Well, for one, it paid $634 million (U.S.) in 2007 after pleading guilty to misleading American doctors and patients about the highly addictive nature of OxyContin. That, no doubt, has forced it to be more careful about how it operates and markets products south of the border.

So much so, that Purdue Pharma announced in February that it would no longer “promote opioids to prescribers” in the U.S.

Unfortunately, the pharmaceutical company did not extend that same policy to Canada. It should.

Purdue says it follows rigorous standards for its promotional material and includes a “balance between risk and benefit.”

By now, doctors — and everyone else — know all about the risks of opioids like OxyContin. And information about the benefits is better coming from Health Canada than the company whose stock price rises with sales.

Purdue’s high spending on Canadian physicians “should shatter the myth that we are not exposed to the same level of aggressive marketing tactics as in the U.S.,” said Trudo Lemmens, a professor of law and bioethics at University of Toronto.

He’s right. That’s why we should know much more about the services that Canadian doctors provide in exchange for millions of dollars in payments from drug manufacturers.

And not just Purdue’s $2 million. All drug companies should be transparent about what payments they make to doctors and why.

Last year, 10 of Canada’s largest drug companies voluntarily released information showing they paid Canadian doctors nearly $50 million in 2016.

It’s far from a complete tally: 35 other brand-name pharmaceutical companies and 10 generic drug companies didn’t offer up their payments.

And none of the information includes the names of the doctors who received the money or what it was for.

Payments can be for a wide range of things from consulting and delivering speeches to food and travel to conferences.

And the concern with all of that, of course, is whether doctors who receive money from pharmaceutical giants are more likely to prescribe drugs those companies manufacture.

That incomplete picture is why the Ontario government passed legislation to require pharmaceutical companies to disclose all payments made to doctors.

Full disclosure will make physicians more cautious about accepting payments that may influence how they treat their patients.

The draft regulations of the Health Sector Payment Transparency Act were published in February. They cover a wide variety of payments of $10 or more to regulated healthcare professionals, health facilities and advocacy groups and others. The consultations ended in April but the government didn’t move quickly enough to pass the completed regulations.

And now, with only two days to govern before the writ dropping on Wednesday for the June 7 election, they’ve run out of time.

The Liberals say they are still committed to passing these important regulations. But bringing greater transparency to this corner of healthcare may now depend on whether the Progressive Conservatives and NDP are committed to it, too.

https://www.thestar.com/opinion/editorials/2018/05/05/clarity-needed-on-what-drug-manufacturers-are-paying-doctors-millions-of-dollars-for.html