Canadian drug companies agree to divulge how much they pay doctors, health groups

BY TOM BLACKWELL

ORIGINALLY PUBLISHED: MAR 28, 2016
One critic calls the plan by Canadian drug companies to start publishing statistics on their overall payments to health…
Amid ongoing controversy over the fees pharmaceutical companies pay doctors, 10 Canadian-based firms have agreed to divulge how much cash they hand over to physicians and health organizations every year.
They say the voluntary program should make the financial ties between pharma and medicine more visible – and help “neutralize” charges of conflict of interest.
The firms plan to start publishing statistics on their overall payments to health professionals next year, though will stop short of releasing figures for individual physicians, as now required in the United States.

“To us, building trust is fundamental – to actually meet or exceed society’s expectations,” said Paul Lirette, president of GlaxoSmithKline Canada (GSK). “Transparency is the way to go for us to build trust.”
The program – kickstarted by GSK — has been endorsed by Innovative Medicines Canada, the pharmaceutical sector’s trade association, and Lirette said he expected other companies would join in future.
The participants, all branches of multinational corporations, include Abbvie, Amgen, Bristol-Myers Squibb, Gilead, Eli Lilly, Merck, Novartis, Purdue and Roche.
I think this is very likely an effort to forestall real accountability or real transparency on this issue.

Another 40 members have yet to join, including giants Pfizer, Johnson and Johnson, Bayer and Sanofi.
Critics have long worried about the money flowing from pharmaceutical companies to doctors, such as fees for speeches, participating on advisory committees or working as consultants. Evidence suggests those monetary ties can influence prescribing habits — and that industry-funded specialists can sway other doctors.
Some researchers say the initiative is a small step in the right direction, but questioned how much good it would achieve, given the plan to publish only “aggregate” amounts.

By contrast, the American “Sunshine Act” forces industry to publicly post how much firms give individual, named doctors and hospitals, information readily available on the Internet.
The Canadian plan is “a P.R. gesture at best, and it will produce a largely meaningless set of figures,” charged Sergio Sismondo, a Queen’s University professor who studies links between drug companies and doctors.
Tyler Anderson/NP

“I think this is very likely an effort to forestall real accountability or real transparency on this issue.”
He and Dr. Joel Lexchin, a Toronto emergency doctor and health-policy professor, both called on Canadian governments to follow the U.S. lead, and mandate release of payments to individual professionals.
Jane Philpott, the federal health minister, was unavailable for comment.
The pharmaceutical business has long had close ties with the health-care system, some links more controversial than others. Industry, for instance, funds most drug trials — usually run by outside physicians — that can lead to new medicines.
Other types of fees and gifts that health professionals receive are more contentious.
Edward Gudaitis, general manager of Gilead Canada, said the Canadian companies will release figures in three areas: fees for consulting, speaking and other services provided by health professionals; money given doctors to travel to international functions; and grants provided to some health-care organizations.
Such relationships are actually good for health care, helping physicians stay informed about medical advances, says the Gilead CEO.
“This … will help shine a light on it and provide a level of integrity and comfort for people,” he said. “It’s where society is taking us and industry needs to be.”
Under the U.S. law, drug companies reported US$6.45 billion in payments to physicians and hospitals in 2014, including money for research.
More than 600,000 doctors – about two-thirds of the total – received sums ranging from a few dollars to millions of dollars.
Related
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As illustration of the money’s potential influence, a recent analysis of Sunshine Act data by the Propublica investigative-journalism group found that doctors who receive industry cash are more likely to prescribe pricier brand-name drugs than generics.
“It’s good to see that at least some of the companies are taking an initiative” to be more transparent, Lexchin said.
But he said it is unclear whether the published figures will include the full range of transactions, while much of the sector is not participating.
“We’re still going to be missing a fair chunk of the money the industry is paying to doctors,” said Lexchin.
GSK, meanwhile, says it has also recently launched its own, separate measures to counter perceptions of undue influence on medicine.
It no longer pays sales reps bonuses based on the number of prescriptions doctors issue for their products. And instead of outside specialists speaking on GSK’s behalf to other doctors, such talks are now given only by physicians clearly identified as being on the company staff.

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