Shine a light on payments
When Dr. André Lalonde presented a seminar to doctors at a dinner in 2014 on how to treat lower back pain that is not extreme but constant, he mentioned he prefers the drug Cymbalta.
That just happens to be one of the drugs made by Eli Lilly, the company that paid Lalonde to give the speech. Neither the doctor, a general practitioner from Laval, Que., nor the company would say how much he was paid. But Lalonde insisted: “I am free and independent and I speak my mind, not theirs . . . I do not sell anything.”
That may well be. But the optics are bad, regardless of any doctor’s good intentions. To independent outsiders it appears that pharmaceutical giants who foot the bill for such seminars are trying to influence the doctors who give the speeches to promote their products, and the physicians who attend to prescribe them. The perception is so bad that 10 Canadian pharmaceutical firms now say they will report how much cash they hand over to physicians each year in an effort to combat the negative connotations.
Any step aimed at shining a light on the relationship between doctors and pharmaceutical companies is welcome. But this one doesn’t go nearly far enough. That’s because the companies plan to publish statistics on their overall payments to health professionals, not what they give to each individual physician.
What’s needed instead is federal legislation requiring all pharmaceutical companies to divulge how much they give individual doctors. That’s what they are already required to do in the United States under a 2010 law called the Physician Payments Sunshine Act.
Anything less is, as one critic describes it, “a PR gesture at best.” The risk is that it could dissuade Ottawa from adopting legislation to make the relationship between doctors and drug companies truly transparent.
Sergio Sismondo, a Queen’s University expert on links between drug companies and doctors, says the amalgamated statistics the companies plan to start publishing next year will be meaningless. Contrast that to the legislation in the U.S., where patients can go online to see “which companies are wining and dining and paying their doctors.” That makes doctors more cautious about accepting payments, and researchers can see “the effects of those payments on how doctors prescribe.”
Indeed, the U.S. legislation even shows patients if their doctors received free meals from drug companies. That’s important because there is a debate underway in the College of Family Physicians of Canada about whether drug companies should be allowed to sponsor dinner seminars that doctors attend to gain continuing medical education credits — like the one Lalonde spoke at — or whether physicians should pay for the events themselves.
As the Star’s David Bruser and Jesse McLean report, some American doctors’ organizations have banned industry funding of their medical education. They’ve done so because research shows that industry sponsorship biases content. Typically, it emphasizes medication — often the company’s own products — while downplaying treatments like diet or exercise.
It’s time a real light, not a dim one from a handful of pharmaceutical giants, was shone on how doctors learn about new treatments. Legislation is the way to do it. Otherwise, as Dr. Sheryl Spithoff, a family physician at Women’s College Hospital notes, we’re allowing “people to educate us who have other goals.”
Pharmaceutical firms now say they will report how much cash they hand over to physicians each year. That’s not good enough