Healthy Skepticism Library item: 14684

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Publication type: news

Dix A.
Don't pull the plug on the Therapeutics Initiative
The Vancouver Sun 2008 Nov 28
http://www.canada.com/vancouversun/news/editorial/story.html?id=bce9afed-4237-490a-bc2a-44013a5a7b8e

Full text:

The provincial government is set to pull the rug out from under a world-renowned success story that is credited with saving lives and sustaining our public health care system.
The Therapeutics Initiative has put British Columbia on the leading edge of prescription drug policy, earning praise and envy for its effectiveness. Yet Victoria seems determined to undermine its effectiveness and B.C.‘s reputation.
The Therapeutics Initiative was established in 1994 by UBC’s department of pharmacology and therapeutics to “provide physicians and pharmacists with up-to-date, evidence-based, practical information on prescription drug therapy.”

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Since then, the TI has worked independently of government and the pharmaceutical industry to provide expert advice to B.C.‘s Pharmacare program, physicians, pharmacists and the public. It has saved lives and given priority to health outcomes in drug policy.
But the government is about to put an end to the Therapeutics Initiative. This will mean the loss of independent reviews and the ability to ensure that Pharmacare’s and the public’s expenditures on prescription drugs meet the test of safety and effectiveness.
Last November, the government appointed a pharmaceutical task force, a committee that included representatives of the brand-name drug industry. It relied heavily on “staffing, information and research supports” provided free of charge by Rx&D, the multinational pharmaceutical industry’s lobby group.
The report of the committee, echoing a long-standing demand of the industry, recommended that the TI be abolished — and the government has given notice that that is exactly what will happen. Today, at a closed door, the government will unveil how the committee’s recommendations will be implemented. Those groups most affected by the decision, including independent researchers, consumer advocates and the public, will have to wait outside for the news about how the role of the TI will be replaced by a more pharmaceutical industry-friendly alternative.
But the plan to abolish the Therapeutics Initiative has raised concern across the country and around the world. B.C. seniors’ groups and family physicians have urged the government to strengthen, not abolish, the TI. Andre Picard, one of Canada’s premier health writers, called the TI “a gem of Canadian public policy,” while the Canadian Health Services Research Foundation called it an “outstanding effort [that] has positively influenced prescription practices” in B.C.
The Therapeutics Initiative has also been praised by B.C.‘s auditor-general who, in 2006, told the health minister that the TI had been “successful in guiding physicians to practice cost-effective prescribing.” His report recommended that the government significantly increase support for programs such as the Therapeutics Initiative “that encourage appropriate drug use through physician best practices in prescribing.”
From Europe, the prestigious International Society of Drug Bulletins, based in Verona, Italy, credited the TI with “minimizing drug-related harm and fatalities” and urged the government “to reconsider the opinion made by this conflicted task force.”
Faculty at Spain’s International School of Public Health told the government that “because [of] the importance of the Therapeutics Initiative not only in Canada, but all over the world, we are asking you to retain and strengthen it.”
The TI has provided Pharmacare with objective assessment of the evidence to support coverage of prescription drugs, particularly in regard to health outcomes and mortality rates. It has saved lives — the most well-known example is its assessment of the evidence regarding Vioxx, which led to Pharmacare’s decision not to list the drug as a first-line treatment. It has been estimated that this saved up to 600 lives, particularly among the elderly.
The TI has helped B.C. sustain our public health care system and has put the province on the leading edge of prescription drug policy. Yet the Liberal government seems determined to stand shoulder to shoulder with the pharmaceutical drug industry to undermine its effectiveness and B.C.‘s reputation. Premier Gordon Campbell has been stopped before from pursuing his agenda to undermine the independence of the Therapeutics Initiative.
This time he has truly stacked the deck. He has excluded his own Ministry of Health and weighted his committee with pharmaceutical industry supporters and representatives, defying both science and common sense.
For those who believe we need an independent voice to protect prescription drug users and a means to ensure the sustainability of health care, now is the time to speak out.