Healthy Skepticism Library item: 14692

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Publication type: news

Cassels A.
Public has little presence in PharmaCare talks
The Times Colonist 2008 Nov 26
http://www.canada.com/victoriatimescolonist/news/comment/story.html?id=3bd095bb-1e2c-4f40-81d9-ebb644a3cf5e&p=1

Full text:

On Friday, B.C.‘s PharmaCare program, the main government program that provides pharmaceutical coverage for citizens, will be engaging its “stakeholders.”
It’s always positive when public programs make the effort to consult with the people who are most affected — in this case, those who take prescription drugs, or almost all of us.
As Health Minister George Abbott recently said: Public involvement supports government’s commitment to transparency and accountability.” Amen to that.

But if we look a bit closer at past consultations, we might want to hold off any celebrations.
The last PharmaCare “stakeholder” event, back in July, was an adventure in faux public involvement.
Getting together mostly drug industry people, folks from retail pharmacies and the biotech industry, plus a smattering of people from disease groups known to dine on pharma’s dime to discuss the future of PharmaCare was not just crass, but pathetic.
By all accounts, that consultation was stacked about four-to-one in favour of the industry vs. the public interest, a situation so unbalanced that a pair of researchers at the University of British Columbia wrote to the ministry asking why more than 80 per cent of the “stakeholders” were drawn from pharma’s supply chain.
This plea for real public involvement had little traction. Not only is the invitation list for this Friday’s consultation secret, the meeting will most certainly be stacked with the usual pharma lobby types and a sprinkling of their paid friends from a variety of sectors to give it an air of “balance.”
The reason this is such an important issue is that any stakeholder consultation so obviously biased will not actually be guided by the public interest in the deliberations. The public wants affordable, effective drugs and other treatments, without having to mortgage their kids’ futures.
What a stacked meeting full of drug company executives will deliver is a whitewash — in this case, likely an attempt to ram through a set of recommendations from another horribly biased process, the recent Pharmaceutical Task Force.
Earlier this summer there was a bit of a hullabaloo over the task force, set up by the provincial government with strong representation from the brand-name pharmaceutical industry, as well as academics and clinicians funded by the industry.
The task force was ostensibly established to review the future of drug coverage in B.C. It produced a report so bizarre that some of us were left wondering what kind of pills the members were popping when they wrote it.
Some suspect that what is being acted out in the task force charade is a battle between the Ministry of Advanced Education and the Ministry of Health. The advanced education folks, backed by the drug industry, are trying to scuttle the discipline of B.C. PharmaCare, because it stands in the way of oodles of high-tech jobs in B.C.‘s biotech industry.
Among the task force’s stinkier recommendations was one which said we should scrap the one agency that has helped B.C. PharmaCare control costs and make prescribing more rational: the University of B.C.‘s Therapeutics Initiative.

This small group of physicians and researchers have not only helped keep B.C. from swerving into the path of the oncoming truck known as Vioxx, the arthritis drug that was responsible for an estimated 50,000 deaths in the U.S. alone. They have also been tossing a lifeline to B.C. doctors who are often at risk of drowning in the pharmaceutical industry’s spin machine. So, we have a group of stakeholders — which consists of drug companies, their paid cheerleaders in retail pharmacy and biotech, and their ‘friendly’ patient groups — sitting down to help the B.C. government decide the future of a $1-billion per year drug plan. Sweet.
I suspect B.C. citizens won’t be sitting down for this one. Maybe the government can’t understand how offensive such a biased “stakeholder” consultation looks to the public, especially when there’s so much at “stake.” We’ve got a well-managed drug plan in B.C. that is the envy of the rest of Canada, with the lowest per-capita pharmaceutical spending and some of the most generous coverage in the country.
Yet if we to allow PharmaCare’s future to be dominated by the interests of the pharmaceutical companies, we should be prepared to spend money like drunken sailors as they do in Quebec or New Brunswick. If we spent on par with those provinces, we’d be sending another $300 million per year to the drug companies.

That’s a lot of money — and a huge prize for the drug companies — and the reason why the pharmaceutical companies and the biotech industry are working so hard to convince the government that they need to infiltrate, modify and contaminate B.C.‘s drug plan decision-making in order to “grow the knowledge economy.”
Perhaps an election can help clear the air, letting the real “stakeholders” have their say and decide if they want private interest to dominate decisions around how to manage our public drug bill.

Alan Cassels is a drug policy researcher at the University of Victoria and the author of The ABCs of Disease Mongering: An Epidemic in 26 Letters.