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Drug Firms' Sway over BC's New PharmaCare Task Force

Most panel members have strong links to drug industry.

By Andrew MacLeod, 28 Nov 2007, TheTyee.ca

Health Minister George Abbot (head shot)

Health minister Abbott: wants drug price review.

When Health Minister George Abbott announced the names of the nine people on his new pharmaceutical task force, the government's press release described the panel's chair, Don Avison, as a lawyer with experience working for several ministries and noted he is president of the University Presidents' Council. But his resume is longer.

The release failed to mention that Avison also sits on the board of the LifeSciences British Columbia, a lobby group formerly known as B.C. Biotech that includes dozens of drug companies.

The oversight is intriguing, considering the strong drug industry flavour of the panel, which is supposed to advise health minister George Abbott on pharmaceutical policy.

At least five of the nine members have clear ties to the drug industry.

"It's a good idea to do this, but the composition of the board is highly debatable," says Adrian Dix, the NDP health critic. "I think it's extraordinary and bizarre the pharmaceutical representatives were put on the panel this way. It's really unfortunate patients are so poorly represented here."

Drug companies give to BC Liberals

The highest profile drug industry representative on the task force is Russell Williams, the president of Canada's Research-Based Pharmaceutical Companies (Rx&D), a national lobby group with members from some 50 drug companies and whose directors include the presidents, CEOs and other top officials from 14 of the countries biggest drug manufacturers.

"The job of the president of Canada's Research-Based Pharmaceutical Companies is to represent the interests of the pharmaceutical industry," says Dix. "That's what he does."

Other task force members with drug ties include David Hall, a senior vice president in charge of government and community relations for the drug company Angiotech Pharmaceuticals Inc. According to the B.C. Liberal's most recent annual financial report, Angiotech gave the party $2,990 in 2005.

Many other drug companies are also Liberal donors, including GlaxoSmithKline Inc. ($6,288), Wyeth Canada ($5,488) and Pfizer Inc. ($3,699).

Task force member Susan Paish -- who chaired the three person commission which recommended in an April report hiking the pay for MLAs -- is the chief executive officer of the drugstore chain Pharmasave Drugs (National) Ltd., which owns about 400 pharmacies and "health centres" in Canada.

Then there's Robert Sindelar, the dean of the faculty of pharmaceutical sciences at UBC. He is also, like Avison, a board member for LifeSciences British Columbia, the industry lobby group. The group's website says Sindelar's research on drugs and the human immune system has led to six patents in the U.S., plus several in other countries.

The task force is to advise Abbott on how to get maximum value for the $1 billion a year the province spends on drugs through PharmaCare. Since 2001 when the Liberals were first elected, PharmaCare spending has jumped by nearly 60 per cent.

'Price fixing' alleged

Dix, as it happens, is a type one diabetic who takes insulin to help regulate his blood sugar levels. Four times a day he uses test strips to measure the glucose in his blood. They cost pennies to make, he says, but the company charges $1 per strip.

As an MLA, Dix makes enough money that he pays for the strips himself and figures he's spent around $20,000 on them over the years. The B.C. government, which picks up the tab for people with lower incomes, spends $29 million a year on the strips. "[The manufacturers] are price fixing," Dix says. "They're price fixing at the expense of people with a chronic disease."

That's what makes the industry flavour of the new panel so disturbing, says Dix. "Do you think the representatives of the industry are going to look at that problem and say, 'We should charge half of what we charge now'?"

The government needs someone like researcher and writer Alan Cassels on the panel, Dix says, to advocate for recommendations that are in the best interests of patients and the public.

Pricing policy targeted

The panel is to look at a number of things the industry has long disliked, including reference-based pricing, where the government will pay for the cheapest drug in a class if all work equally well. It will look as well at the Common Drug Review process and the Therapeutics Initiative, a program that in the past has been credited with saving lives by delaying the funding in B.C. for drugs like Vioxx. It will advise Abbott and the government on how to "optimize the decision-making process for what drugs are covered under PharmaCare."

Of course "optimize" will have a different interpretation depending on whether you are the government or a patient buying the drugs, or a store or company selling them, says Colleen Fuller, the president and co-founder of PharmaWatch in Vancouver.

"To have a task force that is set up to address these issues, it's not because of public demand, it's because of the pharmaceutical industry," she says. "There's absolutely no question where they're going with this. The report's probably already written."

Reference pricing now only covers five classes of drugs, she says, but it should be expanded to other kinds. "We've saved so much money because of that program. It's kind of a no brainer it should be expanded to cover other classes of drugs."

That's not something the panel is likely to recommend, she says, adding nobody on it is likely to be a strong advocate for patients. "I'm very agitated about the task force. I see it as a complete cover up for a policy that's going to lead us to a quagmire of higher prices."

'Important stuff'

Health Minister Abbott declined an interview but sent a statement saying the panel members were chosen for their expertise. "This is an expert advisory group that will work together for a short period of time to provide innovative ideas for the Minister's consideration."

Ministry spokespeople could not explain how the government chose task force members, other than to say they tried to get a broad representation of perspectives.

Nor were there responses to questions about what kind of conflict of interest disclosure members had to make and whether there would be opportunities for the public or experts to present information or arguments to the panel.

"This is important stuff, no question," says Steve Morgan, an assistant professor in the University of British Columbia's department of health care and epidemiology and an expert on the causes and consequences of rising drug spending. "My research convinces me policies that pay for evidence-based health care, for what works essentially, are the best opportunities to contain costs in the pharmaceutical sector."

He says he is keen to hear about the consultation process and would like to share his research with the panel. "I hope the outcome of the process is good, and I do hope British Columbians can get involved," he says.

With the task force scheduled to give Abbott its advice by the end of January, it appears there will be little time to hear considered opinions.

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