Ford PCs leave drug-company transparency law in limbo

Theglobeandmail.com
November 6, 2018
Kelly Grant

A law that would have made Ontario the first province in which drug companies were forced to publicly disclose their payments to doctors is in limbo with less than two months to go before the data collection was supposed to begin.

Premier Doug Ford’s Progressive Conservative government has not enacted the regulations that would bring into force the Health Sector Payment Transparency Act, legislation that was hailed as a major step toward openness in medical marketing when the former Liberal government passed it nearly a year ago.

Health Minister Christine Elliott’s office would not say whether the Tories intend to proceed with the transparency law or abandon it.

In the meantime, the legislation has been left to languish alongside other laws the Liberals passed but did not execute before they were swept out of office in June.

“We know, in many cases, the health sector did not feel that the prior government engaged in proper consultation when enacting legislation,” Hayley Chazan, the minister’s press secretary, said in an e-mailed statement that declined to answer specific questions about the transparency law. “That’s why our government is broadly consulting with partners in health care and reviewing all legislation that has not yet come into force as part of our efforts to develop a long-term transformational health strategy."

The law would have led to the release of massive amounts of new data about how the pharmaceutical industry tries to influence the practice of medicine in the province.

The physician-advocates and researchers who backed the legislation called that an unalloyed good, but Innovative Medicines Canada (IMC), which represents brand-name drug makers, warned last spring that the legislation was so sweeping it would impose a heavy “regulatory burden” and lead to a “material increase in corporate compliance expenditures” for drug companies.

IMC declined to comment on the status of the legislation on Monday, but said by e-mail that its “members are committed to ethical interactions with health-care professionals.”

Ontario’s legislation would have compelled all makers of drugs and medical devices to divulge payments of $10 or more to physicians, professional medical associations, patient advocacy groups, hospitals, universities and a long list of regulated health professionals, including pharmacists and nurses.

Right now, none of that information must be made public in Canada. In the United States, Japan, Australia and several European countries, searchable databases in some cases allow patients and researchers to look up physicians by name and see how much money they have received from pharmaceutical companies for work such as consulting, delivering speeches, sitting on advisory boards and running clinical trials.

Drug companies in Ontario were supposed to begin tracking payments in 2019 with an eye to reporting them publicly beginning in 2020. (The start date likely would have been delayed even if the Liberals had been re-elected because the draft regulations were not adopted before the election.)

Joel Lexchin, a Toronto emergency-room doctor and pharmaceutical-policy expert at York University, said he has e-mailed Ms. Elliott’s office repeatedly to ask about her government’s plans for the legislation. He said he has not received a response.

“I’ve been pointing out that, as a doctor, I regard this as important for transparency and to increase dialogue between doctors and patients,” he said.

Dr. Lexchin, one of the founders of a pro-transparency campaign called Open Pharma, added that the U.S. Physician Payments Sunshine Act has been a boon to researchers, who have linked its information with prescribing data to see how drug-company payments might influence which medications doctors recommend.

Alan Cassels, a Victoria-based pharmaceutical policy researcher and author, said it was a “major disappointment,” to see Ontario’s transparency legislation lie dormant, especially because British Columbia’s NDP government was looking to follow Ontario’s lead.

A spokeswoman for B.C.'s ministry of health said the government is reviewing the results of consultations on a possible health-sector transparency plan that were held over the summer.

“So much of our health care comes down to the prescription pad,” Ms. Cassels said. “Knowing that that there are organizations that are tilting the prescribing pen is, I think, really important. It affects all of us.”