Most provinces turn to the Common
Drug Review for advice on public coverage of medications.
For therapies that fall outside the Common Drug Review,
British Columbia relies on an independent review and
clinical education body housed at UBC called the Therapeutics
Initiative (TI). The TI review process has been praised
for outcomes such as preventing widespread use of COX-2
inhibitors in BC, medications which turned out to have
a poor risk-benefit ratio.
The TI has now come under attack,
however. A government-appointed task force on the province's
pharmaceutical policy is composed in large part of people
with ties to the pharmaceutical industry, including
Russell Williams, the president of the main industry
lobby group, Rx&D. Its April 2008 report concluded,
without substantiation, that the TI is "widely regarded
as being in need of either substantial revitalization
or replacement." The panel recommends the TI should
cease conducting drug reviews and educational activities
altogether, suggesting that they have not been "unbiased
and evidence based."
In barely concealed contempt for
the TI, which is explicitly designed to keep the evaluation
process shielded from industry influence, the panel
suggested a new process that includes "disease-specific
experts." Although experts have a lot to offer, the
fact is that many have conflicts of interest because
they are involved in research and education funded by
the pharma industry.
Big Pharma spreads its money around,
including to Health Minister George Abbott's party,
the BC Liberals. The Abbott-appointed Pharmaceutical
Task Force illustrates how commercial interests can
influence health policy if we let them, and why Canadians
should hesitate to allow commercialization of other
aspects of the healthcare system. Once corporate interests
are let in, their lobbyists want a say in whatever government
does. — Dr Randall F White, Vancouver, BC
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