Drug companies should be required to reveal payments to doctors, says author of book on the issue

The Canadian medical profession is too close to pharmaceutical companies for comfort, warns a Toronto physician and expert in pharmaceutical policy.

Dr. Joel Lexchin, author of Doctors in Denial, says Canadians deserve better accountability about how much money pharmaceutical companies are spending to try to influence doctors and the health industry.

Lexchin’s book – which raises concerns about ties between doctors and the pharmaceutical industry — is out just as Canadians are getting a first look at some of the money doctors received from drug companies last year.

Ten companies released information earlier this month about how much money they gave to physicians. The voluntary move by the companies comes at a time when there is growing pressure for Canada to make it mandatory for pharmaceutical companies to report any money given to a doctor — something other countries, including the U.S., do.

The 10 drug companies in question — out of about 45 in total — gave more than $48 million to doctors in 2016. But the information was incomplete in some cases. Some companies only released numbers for part of the year, and none disclosed how much individual doctors received.

Lexchin, who is a professor emeritus at the School of Health Policy and Management at York University, called the information inadequate. There were no details about how the money was spent or how much individual doctors received, he said. Each company simply released a lump sum.

There are no criteria for what drug companies must disclose.

Federal Health Minister Jane Philpott, meanwhile, agreed it would be useful for people to see how much doctors were receiving from drug companies, but said it is a provincial issue. In Ontario, Health Minister Eric Hoskins has said he is considering forcing drug companies to reveal payments to individual doctors and hospitals.

Lexchin, who has long advocated for change in pharmaceutical policy, said the federal government should take charge of the issue and require companies to disclose a list of doctors they have made payments to and the amount.

His book details the influential connections between pharmaceutical companies and medical students and organizations, as well as individual doctors.

Lexchin said one of the lessons of the opioid epidemic is how much influence drug companies can have over individual doctors and what impact that can have on prescribing. Purdue, the company that manufactures OxyContin, has been fined more than $600 million in the U.S. for misrepresenting how addictive its product is. It has never been fined in Canada.

Lexchin said Canadians are “being pretty naïve” to think what has gone on in the U.S. with doctors and pharmaceutical companies doesn’t happen here.

Among other things, he said, doctors often underestimate the impact their contacts with the pharmaceutical industry will have on them.

“Multiple studies have shown that doctors have doubts about the ability of their colleagues to remain unaffected by gifts from drug companies, attending sponsored dinners or other interactions with company representatives, but believe that they themselves are immune from being influenced.”

The forward to his book is written by Dr. Brian Goldman, who hosts White Coat, Black Art on CBC radio and is a public speaker. Goldman writes about his awakening to the influence of “Big Pharma.”

Goldman was hired by Purdue to develop and teach a curriculum on safe and responsible prescribing of opioid drugs to patients with chronic pain. But then he began to see first hand doctors prescribing large doses of opioids without screening patients or monitoring them for addiction.

He stopped giving lectures for Purdue or any other drug company, saying, “we thought we were providing a balanced educational message. It is obvious that the benefits of opioid therapy were exaggerated, and the risks underplayed.”

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