Drug companies would be forced to reveal payments to doctors under new Ontario legislation

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The Ontario government plans to unveil legislation Wednesday that would force drug companies and other businesses to publicly divulge the payments they make to health professionals, answering long-standing complaints about industry influence on the medical profession.

Based on similar systems in the U.S. and elsewhere, the law would be the first of its kind in Canada, and likely put pressure on other provinces to follow suit.

Its focus would be the fees companies pay doctors and some other health professionals to sit on advisory committees, give talks to fellow physicians and perform other work, not to mention the free lunches, dinners and samples offered by many firms.

Studies suggest that such financial links can negatively affect how doctors treat their patients.

The law would also cover money paid to health charities, hospitals and other organizations, and the somewhat less controversial funding industry provides for research.

“Drug companies give money to doctors and other health professionals for one reason – to help sell their products,” said David Juurlink, a doctor, pharmacologist and health-policy expert at Toronto’s Sunnybrook Health Sciences Centre. “The objectives of drug companies are often at odds with what doctors’ objectives should be, and what patients want.”

Dr. Eric Hoskins, the province’s health minister, downplayed questions of financial conflict of interest Tuesday, stressing instead that releasing the information would boost the system’s transparency.

“This is good for patients, and this will allow them to make better and more informed decisions about their health care,” he said in an interview. “(It also) helps us get a clear understanding of when such transactions are appropriate or when they might not be. We really don’t know what the nature and volume of transactions are.”

Hoskins said some financial relationships between health professionals and industry are quite positive.

He may be looking to soften the blow for Ontario doctors, many of whom are already furious at the province’s Liberal government over funding cuts and other measures, and similarly irate at the federal Liberals’ proposed tax changes.

The Ontario Medical Association will wait to see the actual bill before weighing in on the topic, a spokesman said Tuesday.

Under the proposed law, companies would have to release payments above a set dollar level, for a list of professionals and groups still to be determined. The government would then make that information available to the public online, said an official in Hoskins’ office.

The first round of disclosures would likely be made in 2019, allowing industry time to gather and disseminate the data, she said.

I think it had a huge role to play in the genesis of the opioid crisis

One company – GlaxoSmithKline (GSK) – helped convince several other drug firms in Canada to voluntarily adopt a limited version of the idea earlier this year, releasing total amounts of payments without naming individuals. It applauded the province’s decision to go a step further.

“We need those co-operations between the nurses, the doctors, the health-care organizations to be able to get to the patients and meet their needs,” said Annie Bourgault, GSK Canada’s ethics & compliance officer. “If we don’t disclose at an individual level, we risk people wondering ‘What’s going on’ … (and) saying ‘Why are they even having those relationships?’ ”

Among a series of studies on the issue, one published last year and based on data from the American “Sunshine Act,” found that even doctors who received a single meal valued at less than $20 from a pharmaceutical manufacturer were more likely to prescribe the drug being promoted.

The issue has come to the fore recently amid the opioid addiction and overdose epidemic, which many experts trace in part to the industry-funded specialists who encouraged general practitioners several years ago to more freely prescribe narcotic painkillers.

“I think it had a huge role to play in the genesis of the opioid crisis,” said Juurlink.

Specialists who were paid in some cases hundreds of thousands of dollars “told us things about opioids that were simply untrue … based on anecdotes and wishful thinking.”

Had the extent of their financial ties been more apparent, the impact of that advice might have been much less, Juurlink said.

But the GSK’s Bourgault said the money that passes hands to compensate for professionals’ time should not affect how they do their job.

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