Federal Health Minister Jane Philpott says she's concerned that a physician with financial ties to Big Pharma was allowed to vote on new national standards for prescribing opioids.
McMaster University received just less than $500,000 in federal funding in 2015 to revise Canada's out-of-date prescribing guidelines. In their application for funding, officials at McMaster pledged that all members of the voting panel will be required to have no financial conflicts of interest.
However, the officials did not honour that pledge. The Globe and Mail has reported that Sol Stern, a family doctor in Oakville, Ont., and one of 13 panel members who voted on the standards, has been a paid speaker and advisory board member for drug companies, including the pharmaceutical giant whose pain pill triggered Canada's deadly opioid epidemic.
"Well, certainly it's concerning," Dr. Philpott told reporters on Monday when asked about Dr. Stern's drug industry ties. "We have made very specific requests to McMaster University to be absolutely sure that there were no conflicts of interest in the participants who took part in the survey."
Jason Busse, an associate professor at McMaster's department of anesthesia and co-lead of the group that drafted the standards, said in an earlier e-mail response to The Globe that the group made an exception for Dr. Stern because his industry-sponsored talks represented a "balanced approach" to opioids. Dr. Stern "reassured us he had no overt bias either strongly in favour or strongly opposed to opioids for chronic pain," Dr. Busse said.
Dr. Stern received remuneration from four drug companies, including Purdue Pharma, maker of the prescription painkiller OxyContin, according to his declaration form posted online last week. A continuing Globe investigation has traced the roots of Canada's opioid epidemic to the introduction of OxyContin in 1996.
The decision to approve Dr. Stern as a panel member has shrouded the new prescribing standards in controversy. Medical experts said physicians who get paid to produce educational seminars about opioids by a company that makes the drugs have a conflict and should not be allowed to vote on guidelines that advise doctors on how to prescribe painkillers.
"Anyone who received money from Purdue at any time from 2000 onwards should not have been allowed any input on the guidelines," said Paul Cary, a family doctor in Cambridge, Ont., who treats many patients dependent on opioids.
The standards, unveiled last week by McMaster's Michael G. DeGroote National Pain Centre, are aimed at reversing practices developed two decades ago, when doctors began prescribing opioids to relieve moderate to severe pain as pharmaceutical companies promoted their benefits. Purdue paid doctors, known as key opinion leaders, to help spread the word in the medical community that OxyContin posed a lower threat of abuse and dependence to patients than other painkillers. Those claims turned out to be untrue: Purdue and three of its executives paid $634.5-million (U.S.) in 2007 to settle criminal and civil charges against them for misbranding OxyContin as less addictive than other medications.
McMaster officials had promised Health Canada that they would avoid a repeat of what happened in 2010, when one-third of the panel members working on an earlier version of the prescribing standards had ties to drug companies.
Dr. Philpott said she learned only recently about the problem with the latest version.
"I am still working to get more information to determine what our next steps will be on that," she said.