Social Policy in Ontario

We don’t know.

What was the money for?

We don’t know that either.

We really should. When pharmaceutical companies dole out millions of dollars to doctors, hospitals, universities and others working in the public health care system, it should be done in a public way to maintain trust that it’s all above board. And not just for 10 big drug companies, but all of them.

Ontario has already passed legislation to make that happen — if only the Doug Ford government would enact the regulations to bring it into force.

The former Liberal government passed the Health Sector Transparency Act but didn’t get the necessary regulations in place before the legislature was dissolved ahead of last year’s Ontario election. It would require pharmaceutical companies to disclose all payments of $10 or more to health-care professionals, health organizations and advocacy groups.

Unfortunately the Ford government, which has no end of appetite for talking about how health care needs to be restructured for the good of Ontarians, has shown no interest in moving ahead with this simple and necessary change.

Public disclosure already happens in the United States, so requiring it here would not be an undue regulatory burden for these companies.

Indeed, U.S. disclosures and academic research is how we know that American doctors who get money from opioid manufacturers tend to prescribe those drugs more often than their colleagues who don’t receive such payments.

Why wouldn’t we want to know if the same thing is happening here?

Transparency helps build trust in the health-care system. Secrecy, especially when it has to do with financial payments for unclear services, breeds distrust.

Payments typically cover things such as consulting, delivering speeches, sitting on advisory boards and travel to conferences.

If the payments are made for legitimate reasons, neither the drug companies nor the doctors and health-care organizations have anything to be concerned about. But public disclosure has a tendency to make people double-check their motivations and more clearly assess potential conflicts of interest.

The only reason we even get to know that 10 drug companies made nearly $77 million in Canadian payments last year is because they have voluntarily made this information public.

This is the third year for this voluntary disclosure of aggregate payments. It should be the last year that companies get to choose what to disclose or whether to disclose at all.

Innovative Medicines Canada, an industry association for pharmaceutical companies, has said voluntary disclosure would enhance public trust in healthcare. That may be the goal, but the voluntary route won’t do that.

For starters, the association represents more than 40 companies, yet only 10 of their members have chosen to disclose anything. And they are only disclosing aggregate Canadian information — $42 million to health-care professionals, $32 million to health-care organizations and $2 million on travel expenses in 2018.

That’s such a small slice of the information that no one can figure out what it actually means. It’s a bit like a doctor giving a patient the drug they need but leaving them in the dark about what dose to take or what the side effects might be.

Incomplete information isn’t a good idea anywhere in the health-care system. And there’s no reason whatsoever that the public shouldn’t know what pharmaceutical companies are paying individual health-care providers and what that money is for.

The Ford government should stop stalling and enact the regulations needed to finally give Ontarians the full picture.

https://www.thestar.com/opinion/editorials/2019/07/02/time-for-ontario-to-make-drug-company-payments-public.html