British Columbia is planning to join Ontario in forcing pharmaceutical companies to reveal their payments to physicians, patient groups and other health-care organizations.
Consultations are set to begin in Vancouver and Victoria next month on a potential health-sector transparency program, one that could compel the makers of drugs and medical devices to disclose what they pay individual physicians for delivering speeches, sitting on advisory boards, travelling to conferences and other work.
The province’s NDP government is also considering having companies disclose their payments to patient advocacy organizations and publicly funded health-care organizations, according to a consultation document the B.C. Ministry of Health has circulated to more than 50 groups or individuals.
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Adrian Dix, B.C.’s Health Minister, said payments from pharmaceutical companies are not necessarily a bad thing, but disclosing them would be helpful for patients who want to know if their doctors have a potential financial conflict of interest when they recommend a drug or procedure.
“There’s no question there’s a significant … potential for conflict in those relationships [with the pharmaceutical industry,]” Mr. Dix said in an interview Sunday. “And if you want to put the patient at the centre of health care, then the patient should know what those relationships are.”
Last fall, Ontario became the first province to pass legislation inspired by the Physician Payments Sunshine Act, a U.S. law that makes public a searchable database of all drug-company payments to doctors worth $10 or more.
However, the regulations required to enact Ontario’s law were not finalized before the Liberal government was swept out of power by Doug Ford’s Progressive Conservatives earlier this month. (A spokesman for Mr. Ford said the incoming government would have more to say about the issue after taking office on June 29.)
If the draft regulations are adopted as planned under the Liberals, the first mandatory disclosures in Ontario would take place in 2020, based on 2019 data.
Japan, Australia and several European countries also require drug companies to publicly divulge their payments to physicians.
Ottawa has so far declined to legislate pharmaceutical-industry transparency at a national level, but Thierry Bélair, a spokesman for the federal Health Minister, opened the door to the idea on Friday, saying by e-mail that Health Canada is consulting with other jurisdictions to see how their transparency laws are working.
In the meantime, he added, the federal government is focused on curbing the marketing of opioids, the potent painkillers at the root of an overdose epidemic accelerated by the spread of illicit fentanyl across the country.
Andrew Boozary, a resident physician at the University of Toronto who leads a group of pro-transparency doctors called Open Pharma, said that making drug-company payments public is about more than transparency for transparency’s sake.
“On a system level, the hope is to start weaving different data together to be better informed when trying to tackle public health issues from opioid prescribing to low-value prescribing,” he said. “Right now we’re just riddled with blind spots.”
Researchers have mined data from the U.S. sunshine law disclosures to discover that even a small meal paid for by a drug company can influence how doctors prescribe.
Eric Cadesky, the president of Doctors of BC, said he is glad the government is consulting with physicians because he wants to that ensure a transparency program does not have unforeseen consequences.
“[The pharmaceutical] industry is involved in training, education and research and we want to make sure that those things continue to be funded properly and that the relationship is one that is transparent and proper,” Dr. Cadesky said.
“We want to make sure that those important activities are not negatively affected in an unintended way.”
Innovative Medicines Canada, which represents brand-name drug companies, said in a statement that it welcomed B.C.’s consultations.
Alan Cassels, a Victoria-based pharmaceutical policy researcher and author, praised B.C.’s move, but said he would prefer a national transparency program.
“I think we need these kinds of systems across Canada, not just in B.C.,” he said. “We’re way behind.”