"Big pharma's relationship with your doctor needs some U.S.-style sunshine," argues Canada's largest national newspaper, The Globe and Mail. The authors, Andrew Boozary, Editor-in-Chief of the Harvard Public Health Review and resident physician at the University of Toronto and Dr. Joel Lexchin, a health policy professor at Toronto's York University, believe that Canada should follow the United States' example in increasing transparency.
"By the end of this year, President Barack Obama's Sunshine Act will have drug companies report virtually every transfer of value to doctors and academic hospitals," the article states. "With payments of as little as $10 dollars to be listed on a public website, this marks a serious undertaking in the world's most sophisticated pharmaceutical market." The article notes that "[t]he idea is to have any financial biases in the physician's office out in the open. This might help ensure that the most responsible decisions are being made for the patient – and the patient only."
In a burst of optimism rarely seen in the States, the authors ask: "Surely Canada's publicly financed health care system is free of such competing interests?" They note, however, that "[m]uch of the evidence isn't so assuring."
The authors provide a number of examples:
"A McGill professor has been formally reprimanded for signing her name to an article written by a professional writing firm that was hired by Wyeth (now part of Pfizer) to generate positive publicity for its hormone replacement therapy." But this information is at least 10 years old.
Furthermore, potential conflicts exist due to "financial interests among physicians who craft Canadian practice guidelines" where "80 per cent declared conflicts of interest on the Canadian Cardiovascular Society and Canadian Diabetes Association."
In medical schools, the article notes that "12 of the schools either had no policy or permissive ones about their faculty engaging in speaking activities on behalf of drug companies."
"This gives us little reason to believe that patients are in the know when it comes to their own doctor's involvement."
The authors stress that it will take "strong provincial leadership to hold pharmaceutical companies to account." They are asking the Ontario Ministry of Health to require companies with drugs listed on the Ontario Drug Benefit Program to disclose their payments to doctors. "Some critics have argued that the public wouldn't be interested enough to visit such sites or know what to make of the information," the authors conclude. "The most recent numbers from the U.S. suggest this may not be true. Patients do seem to care about their physician's financial motives, and a culture of openness might just help the lines of communication."
Before jumping into a US style system, the Canadians should watch how the Sunshine Act works in America and learn from our mistakes. With the rate we are going here in the US,, it may be some time before we have an examplar system in place.