Big pharma could be forced to disclose payments to doctors
Nearly $50M paid to health care professionals in 2016
Ontario’s health minister is considering whether pharmaceutical companies should be required to disclose payments made to doctors.
Eric Hoskins’ announcement on Tuesday that he will begin consultations this summer came hours after10 major drug companies voluntarily released data showing they paid nearly $50 million to Canadian health-care professionals and organizations last year.
There was nothing in the disclosures about payments to specific doctors. Rather, they offer a glimpse at the total amount of compensation some pharmaceutical companies provided to Canadian physicians for consulting, sitting on advisory boards, delivering speeches on conditions and treatments, and travelling to international medical conferences.
Only 10 of the more than 45 members of Innovative Medicines Canada, an industry association for brand-drug manufacturers, voluntarily released payment information. Of those, just four companies released data for all of 2016.
Calling the drug company disclosures a “positive step” toward transparency, Hoskins said, “Our system is strongest when patients and the public have access to the appropriate information so they can make informed decisions about their health care. “Our government is committed to strengthening transparency across the health-care sector.” Toronto Dr. Andrew Boozary, a leading advocate for pharmaceutical payment transparency, said the voluntary disclosure by just10 companies does little to inform the public about the financial relationships their doctors may have with drug firms — and the potential conflicts that come with them.
He said the consultations this summer should include discussions on whether companies in Ontario should follow in the footsteps of the United States, where the Physician Payments Sunshine Act requires pharmaceutical companies to release details of payments to individual doctors and hospitals.
Boozary said that when payments were made public in the U.S., “the sky did not fall. The prescribers did not go into hiding and patients did not lose faith in their health-care system.”
Annie Bourgault, head of ethics and compliance at GSK Canada, said she welcomes the health minister’s announcement and hopes it prompts more drug companies to disclose payments.
“It’s really essential to build patient trust through transparency,” she said.
Bourgault said the drug and vaccine manufacturer is ready to release doctor-specific payment information, but said the proper model of disclosure must first be determined with input from the government, the public and drug and medical device makers. “Now you see some companies disclosing, some not, some just a few months. We’d like to go to the next level but we need do it with an . . . approach so every stakeholder is being involved in making the right model,” Bourgault said.
“Our government is committed to strengthening transparency across the health-care sector.” Health Minister Eric Hoskins
GSK had been working for more than two years with Innovative Medicines Canada to get the voluntary disclosure program up and running.
The company gave out just over $2 million last year.
The voluntary disclosure is broken down in three types of payments: money to health-care professionals for consulting and other services; funding to health-care organizations such as hospitals and universities; and payments to bankroll travel to international conferences.
Of the companies that chose to disclose their payments, Merck topped the list with $9.4 million in payments, the majority of which went to individual doctors for consulting or other services.
Roche Canada ranked second with nearly $8.6 million in payments.
Purdue, maker of OxyContin, gave out just over $3 million in 2016.
AbbVie ($6.4 million), Amgen ($5.7 million), Novartis ($4.9 million), Bristol-Myers Squibb ($3.8 million) and Gilead ($2.3 million) disclosed six months’ worth of payment information.
Eli Lilly, meanwhile, released three months of data. The company disbursed just under $2 million.
Hoskins’ announcement did not include details of the exact timing or scope of the consultations.
There have been numerous controversies in Canada over perceived conflicts of interest because of payment relationships.
Most recently, federal Health Min- ister Jane Philpott ordered an independent review of Canada’s new prescription guidelines for opioids because of revelations that a doctor — who was part of a committee of medical experts who voted on whether to accept the guidelines — had received financial compensation from companies that make and market opioids.
In a statement Tuesday, a Health Canada spokesperson said the minister has requested that the agency “look into what could be done at the federal level to facilitate more transparency.”
In recent years, Toronto Star investigations have exposed a number of questionable relationships between big pharma and doctors. Stories detailed industry funding of pricey dinners, alleged altering of studies, and physician endorsements of drugs. With files from Theresa Boyle