News

Fatten Pharma's Bottom Line, Health Ministry Told

Panel wants BC's medicine buys to boost 'economic development' as well as health.

By Andrew MacLeod, 27 May 2008, TheTyee.ca

Adrian Dix

Health critic Adrian Dix: 'A massive gift.'

A report written for the B.C. Health Ministry suggests the government should consider economic factors and whether it is supporting "innovation" when it decides which drugs to pay for through PharmaCare.

Health Minister George Abbott said he agrees the people who make the decisions on what drugs taxpayers pay for should take a broad view. But critics argue the economic needs of drug companies should not influence those decisions.

The report comes from a task force that was stacked with people with ties to the drug industry. The panel also heard from industry representatives and patient groups like the Better PharmaCare Coalition that are funded by drug companies.

"The existing process for listing gives insufficient weight to the value of innovation and essentially none to economic development factors," the report said drug industry representatives told the panel.

The government's pharmaceutical services division makes decisions about which drugs will be publicly paid for. Its goal is to "advance the health of British Columbians by supporting optimal drug therapy." Its first goal is to "support citizens to have the best possible health." It also tries to buy "the best drugs at the best prices."

The report said, "Senior PSD staff confirmed that they do not consider economic development factors to fall within their mandate." The authors added, "This means broader economic factors beyond cost management of the PSD budget (e.g. prosperity and economic development indicators) are not addressed by anyone."

'Best interests'

When the government released the task force's report, it announced it was accepting all of its recommendations and that implementing them would be based on six principles. The first listed is that "the best interests of the patient are paramount."

But another principle said, "The B.C. government values a healthy, competitive pharmaceutical industry that will continue to provide both financial and human resource investments in B.C."

Asked to what degree the PSD should be supporting research and innovation in the decisions it makes, Abbott said, "I agree with that."

The province is a leader in medical research, especially related to cancer, he said, and that should be encouraged. That encouragement has to be balanced with keeping the Health Ministry's budget in control, he said. "We don't want to do that by limiting the range or efficacy of the pharmaceuticals that are being used by the public, so we need to do it by negotiating as well as we can to produce the best results that we can."

So, does that mean the province would make decisions on what drugs to pay for based on the economic needs of drug companies? "I don't think they're saying though that we should buy X over Y because one is produced in Canada and the other isn't," said Abbott. "I think they're just saying we should think about that in terms of the broader equation. I hope that's what they were saying."

'Wrong priority for PharmaCare': NDP's Dix

NDP health critic Adrain Dix said it is unclear what exactly the task force meant.

"What economic development factors are they talking about?" he asked. The public drug plan should not be seen as a way to support the economic needs of pharmaceutical companies, he said. "If that's what they're suggesting, that's the wrong priority for British Columbian health and the sustainability of the PharmaCare program."

He also said it is telling that the report failed to address the effect patent laws have on the price of drugs in the province. When Brian Mulroney was prime minister his government extended patents on brand name drugs, as did the federal Liberals when they were in office.

Stephen Harper's minority Conservative government is now extending patents on several drugs for another two years. The extensions drive up prescription drug costs, Dix said. "To not even mention it, and then focus on these other issues? Bias is not a strong enough word to describe what that is."

One of the drugs the federal government is extending the patent on is Lipitor, made by Pfizer Inc. Canadian sales are worth about $1.1 billion a year, he said. Once the patent expires, competition will cut that figure in half. Meanwhile the maker continues to make piles of money from the drug.

Dix said, "This is a massive gift from the federal government, using provincial money and the public's money, to the pharmaceutical industry. That's one drug, in one year. Think about that next time the two governments come out here and offer $2 million to people."

'Convoluted' payments

The panel did however make a case for controlling the amount spent on generic drugs. Generics are chemically the same as brand name drugs, but are sold after a patent has ended and are much cheaper.

About 26 per cent of the drugs bought through PharmaCare are generics. With several popular drugs set to come off patent in the next few years, the report said, by 2012 some 52 per cent of the plan's budget will be spent on generics.

"They really have to attack the cost of generics at this point in time," said George Morfitt, the panel's vice-chair and a former B.C. auditor general.

The problem is not necessarily the price of the drugs, he said, but how they are bought through pharmacies, which get paid a fixed fee by the government, but get rebates from generic companies to offer one drug instead of another. "The whole thing needs to be properly rationalized," Morfitt said. "It's quite murky at the moment. Not so much murky, but convoluted. ...Nobody's quite sure how much money is going to whom and for what."

The Canadian Generic Pharmaceutical Association is prepared to negotiate a new reimbursement system with pharmacies and the government, said the group's director of public affairs, Jeff Connell.

"We think that's good," he said. "We're looking forward to working with the government and our partners in the pharmacy community to develop partnerships to increase the contribution generics make to affordable health care in British Columbia."

Already, he said, 56 per cent of prescriptions filled in B.C. are for generic drugs, but they only take up 26 per cent of the PharmaCare budget. "That's very good. That's value for money."

The NDP's Dix said focussing on the generic makers without looking at the brand name companies is consistent with how the panel was struck. "Everyone knows the main drainer of PharmaCare is the industry themselves, the people who were there on the panel."

The government's acceptance of the task force's recommendations has drawn applause from the industry.

Related Tyee stories:

 [Tyee]

21  Comments:

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  • RickW

    4 years ago

    Will Bill C-51 Figure Into "The Bottom Line"?

    Bill C-51 Will:
    Allow Government agents to:
    -Enter private property without a warrant [Section 23 (4)]
    -Confiscate your property at their discretion, at your cost [Section 23.3 a]
    -Dispose of your property at their discretion, at your cost [Section 23.3 c]
    -Seize your bank accounts without a warrant [Section 23 (2) (d)[
    -Charge you for shipping and storage of your property [Section 23.3a-b]
    -Store your property Indefinitely without paying you for damages [Section 23 (2) (d)]
    -Levy fines of up to $5,000,000.00 / 2 years in jail per offence. [Section 31.1]

    Introduce new legislation that will:
    -Allow laws to be created in Canada, behind closed doors, with the assistance of foreign governments, industrial and trade organizations [Section 30.7]
    -Allow "Crack house style" of enforcement on natural health providers [Section 23.1]
    -Allow enforcement to be considered on more than 70% of Canadians who use NHP's Health Canada Reference
    -Allow the minister, based on opinion, to shut down research without any scientific reason or evidence of risk or harm [Section 18.5]
    -Allow the minister, based on opinion, to allow or disallow market authorizations for Natural Health Products Section [18.7 (1)]
    http://www.stopc51.com/

  • DPL

    4 years ago

    Gordo knows who supports him

    Gordo knows who supports him financialy so deals get sruck. To heck with the folks struggeling to pay their bills. He raised the threshold for lots of couples by linking both parties pensions to save money. A cruel man

  • frances

    4 years ago

    Provincial gov't

    C-O-R-R-U-P-T-I-O-N

  • Booker

    4 years ago

    Industry fronts

    I see RickW links to an industry front website, www.stopC51.com for a snake-oil company. Irony, I guess. Big Pharma is also against C-51.

    Adrian Dix is right on target. The Liberals are in the pocket of industry and there are few media outlets, aside from the Tyee, exposing this. The Liberal's pharmacare panel reminds me of Dick Cheney's energy policy panel (made up entirely of oil company execs).

    Cue the cut-and-paste parade.

  • RickW

    4 years ago

  • Booker

    4 years ago

    Yes

    Quote:
    Is this better?

    Yes, the CBC and Georgia Straight are better than the fraudulent site you linked to before. I do disagree with the comments made by some of the people quoted in those articles. In particular, the "Natural Health" industry should not be exempt from laws regarding fraudulent health claims for their products. To quote the actual Bill:

    Quote:
    No person shall manufacture, process, label, package, sell, import for sale or advertise a therapeutic product in a manner that is false, misleading or deceptive or is likely to create an erroneous impression regarding its benefits, risks, conditions of use, quality, quantity, composition, design, construction, performance, origin or authorization status.

    What's the big deal? The bottom line is: don't lie to consumers. This should apply to the Pharma industry as well as the alternative health industry.

    I'm also wondering why some companies in the multi-billion dollar alternative-health industry have changed their tune now. In the nineties they were actually pushing for this legislation. Is it because Big Pharma, in the past ten years, invested heavily in the altie industry? I don't know, but there is big money involved in so-called natural "remedies", and it's always wise to be skeptical when there are large sums of cash in play.

  • Waldmeister

    4 years ago

    Bill C-51

    On April 28/08 the United States Food and Drug Administration Regulators cited Merck & Co for operating their main vaccine manufacturing facility in an unsanitary condition at West Point, Pennsylvania. This US plant is responsible for producing the Gardasil HPV vaccine made for Canada as well as most child hood vaccines.

    To date there has been no Health Canada quarantine or recall of any of Merck's vaccines shipped to Canada that should be tested for the most obvious reasons.

    Indeed, considering the minister's past investment with Baxter Pharmaceuticals, his lack of action to initiate a Canada wide recall and quarantine of the suspect vaccines appears to demonstrate more concern for the profits of Merck

    Merck, one of the worlds largest drug companies, is now noted for planting ghost written science fictions in 'reputable' medical journals extolling the virtues of its drugs.

    Unlike Merck's anti-inflammatory drug Vioxx, that caused heart attacks and killed a great number of users, Canada's natural health products industry has demonstrated a remarkable safety record of no fatalities over the last 40 years.

    Under the circumstances the Health Minster's concern for the safety of natural health products rings rather hollow.

    The overweening influence of drug cartels on the federal and provincial governments is the primary reason why health (sickness) care is the fastest growing failing business in Canada.

  • Waldmeister

    4 years ago

    Bill C-51

    The introduction of Bills C-51 and C-52 by Prime Minister Harper and Health Minister Clement appears to be a consequence of Health Canada getting trashed in Alberta's High Court by a small vitamin company.

    In 2003 Health Canada launched an attack on a group of mentally ill patients and Truehope, the vitamin company who supported them with a product called Empower Plus. Health Canada and the RCMP stormed the Tuehope support centre with 17 armed officers and agents seizing records and computers and cutting off the help required by the patients.

    Health Canada, through Canada Customs, seized shipments of the product - an inexpensive vitamin and mineral formulation - that was actually helping tens of thousands Canadians get over their bi-polar disorder and enabling them to stop using costly ineffective anti psychotic drugs. Recent medical studies show such drugs are not only ineffective but actually make the user's symptoms worse and cause many to be driven into murderous rages and suicide.

    However, as if such actions were not enough, Health Canada forced the University of Calgary to stop a clinical trial of this vitamin therapy even though the Government of Alberta had funded it. Such an arbitrary action gives the lie to claims by Health Canada and echoed by Minister Clement that they must have proof of safety and efficacy. Safety and efficacy is the raison d'être for all clinical trials.

    If passed, Bill C-51 gives Health Canada the right to authorize or prevent clinical trials. Such power will kill the incentive for progress in science and medicine in Canada. When universities can no longer do research independent of interfering government bureaucrats it is no longer science but something else.

    60 years ago the published research of Canadian scientist and physician Abram Hoffer PhD MD established the connection between vitamin, mineral, and other nutrient deficiencies and mental illness. The problem then as now is the fact drug cartels can not patent vitamins so Dr. Hoffer's research was ignored, suppressed or falsely denigrated as unproven.

    Imagine! Fifty dollars worth of vitamins per month replaces anti-psychotic drugs worth $1,200 a month and eliminates bi polar disorder without side effects! Is it any wonder Big Pharma and their friends in the health bureaucracy are worried - including senior government regulators who authored Bill C-51 in an effort to suppress the truth?

    Truehope was found innocent by necessity and instructed by the judge to continue to supply the supplement under legal and moral responsibility.

    Although the agents admitted knowing they were injuring people through their actions, they stated under oath they care only about policy and directive. And what happened to the more than 300 mentally ill Canadians that became unreachable? In the months and years following, reports of ospitalizations and suicides during the seizures have surfaced. No Health Canada agent has ever been charged.

  • Booker

    4 years ago

    It's all about commerce

    Quote:
    Imagine! Fifty dollars worth of vitamins per month replaces anti-psychotic drugs worth $1,200 a month and eliminates bi polar disorder without side effects! Is it any wonder Big Pharma and their friends in the health bureaucracy are worried - including senior government regulators who authored Bill C-51 in an effort to suppress the truth?

    This is the kind of garbage that I'm talking about. They put a buck's worth of vitamins in a bottle and charge $75 for it (according to their website) and say it cures major mental illness. They scream persecution when Health Canada tries (with considerable difficulty) to track them down. Then they come on the Tyee trying to get more customers. Then they scream persecution when the government proposes that they stop their false advertising. Just freakin' lovely, and typical. Talk about fattening the bottom line.

    (btw, lithium and anti-psychotic meds don't cost anywhere near $1,200. And there are generics. But who cares about accuracy).

  • Waldmeister

    4 years ago

    Fifty dollars worth of vitamins per month

    Had Booker bothered to read the Alberta High Court's 2006 decision (Regina vs Truehope) he might have learned something instead of dismissing it as garbage.

    The facts are drugs induce significant nutrient losses in the body.

    The anti inflammatory Vioxx caused heart attacks because it increased the need for B vitamins, including folic acid (A fact that has been known since 2000 but Health Canada officials admitted they did not know when questioned in Richmond BC on May 21/08).

    Other non steroidal anti-inflammatory dugs can are just as bad. Acetaminophen overdose (Tylenol) can destroy the liver by depleting if of an important amino acid.

    All statin drugs interfere with a metabolic pathway that produces cholesterol. It is also the same metabolic pathway that produces an important enzyme that is essential for energy output and muscle function - the suppression of which causes muscle weakness and heart failure. Beta blockers, diuretics, steroids, diabetic drugs, trycyclic anti depressants have the same effect. The result is an epidemic of heart failure.

    Antibiotics are even worse. Not only are the B vitamins lost but also vitamins A, C, E, and K. The minerals that are lost include calcium, magnesium, potassium, iron, zinc. These are absolutely essential for a healthy immune function.It is no wonder infections are rampant in British Columbia hospitals.

    The medical profession's excessive application of drugs in their practise together with an appalling lack of knowledge of the consequences of drug induced nutrient depletion is the paramount reason why health care, which is actually sickness care, is the fastest growing failing business in Canada.

    Witnessed the tragic spectacle of an MD losing the right to practise, not because of garage full of bodies but, in the opinion of the College of Physicians of Surgeons, vitamins were being prescribed in preference to Prozac or Ritalin. To hell with the patients well being.

    A little knowledge can be a dangerous thing but ignorance of the fundamentals of nutrition can be down right deadly.

  • Booker

    4 years ago

    Quack medicine

    The court victory was not a victory for mental health.

    The Truehope "clinical trials" have a checkered history. One example -- the doctor (a PhD, not an MD) on the website;

    http://www.circare.org/FOIA/ATIPindex.htm

    And an update from the National Post tells of an object lesson in why patients should avoid quack medicine:

    Quote:
    The new bulletin says Health Canada has received nine reports of serious adverse reactions in Empower Plus users. Patients saw a spike in symptoms of their psychiatric illness, possibly because they switched from regular drugs to the mixture of vitamins and minerals, the department said.

    and

    Quote:
    A leading expert in bipolar disorder also voiced caution yesterday about the nutritional supplement, saying the limited study of the product has far from proven its efficacy. Until there is definitive evidence, patients should be treated with only scientifically proven remedies, said Dr. Lakshmi Yatham, a psychiatry professor at the University of British Columbia, and head of the Canadian Network for Bipolar Disorder

    Why should the therapeutic claims of such products be treated with less seriousness than pharmaceuticals?

  • RickW

    4 years ago

    booker

    Quote:
    The bottom line is: don't lie to consumers.

    As long as we include lies by omission.

    I refer to a post by Andrew Mcleod in another recent thread:

    http://thetyee.ca/News/2008/05/23/DrugWatch/

    The facts are pharmaceutical use induces significant nutrient losses in the body. The brand names that Health Minister Abbott and Premier Campbell seem to prefer are often far worse for this than their generic counter parts or older versions.

    The anti inflammatory Vioxx caused heart attacks because it increased the need for B vitamins, including folic acid. Other non steroidal anti-inflammatory dugs can are just as bad. Acetaminophen overdose (Tylenol) can destroy the liver by depleting if of an important amino acid.

    All statin drugs interfere with a metabolic pathway that produces cholesterol. It is also the same metabolic pathway that produces an important enzyme that is essential for energy output and muscle function - the suppression of which causes muscle weakness and heart failure. Beta blockers, diuretics, steroids, diabetic drugs, trycyclic anti depressants have the same effect. The result is an epidemic of heart failure.

    Antibiotics are even worse. Not only are the B vitamins lost but also vitamins A, C, E, and K. The minerals that are lost include calcium, magnesium, potassium, iron, zinc. These are absolutely essential for a healthy immune function.It is no wonder infections are rampant in British Columbia hospitals.

    The medical profession's excessive application of drugs in their practise together with an appalling lack of knowledge of the consequences of drug induced nutrient depletion is the paramount reason why sickness (whoops!) health care is the fastest growing failing business in Canada. I have witnessed the tragic spectacle of an MD losing the right to practise, not because of garage full of bodies but, in the opinion of the College of Physicians of Surgeons, vitamins were being prescribed in preference to Prozac or Ritalin. To hell with the patients well being.

    The next time our research challenged health minister and premier cry about the high cost of health care in British Columbia let them cry to the drug company financed 'astro turf' consumer groups that lobbied for brand name drugs over generics. That is what you get for relying on "Brand Power."
    Croft Woodruff PhD MH

  • RickW

    4 years ago

    Waldmeister

    I see you beat me to it..........oops!

  • greengreen

    4 years ago

    election issue

    I certainly hope the NDP can make this an issue during the election campaign - both the conflict-of-interest committee and the slant of the whole report.
    This whole mess should be political suicide, not something swept under the rug. Come on Adrian Dix, make news!

  • mopled

    4 years ago

    It's freedom at issue

    Health Canada allows two neurotoxins, aspartame and MSG in food and acetometphene, the destoyer of livers and contributor to liver cancer, as an over the counter drug to name just three instances of the very peculiar double standard on potentially dangerous substances.

    Now, I think there is something weird about that. When known toxic substances are given green lights and fairly harmless things like vitamins, minerals and herbs are to be restricted I feel like I'm living in topsy turvey land.

    As for the attitude of Dr. Yatham, she belongs to a guild that doesn't like competition and seldom punishes its members for bad practice or behavior. We have seen that guild close ranks to protect its own.

    In my experience, Mds seldom have a clue about nutrition or deficiency symptoms and many have been known to refuse the knowledge of what the patient has done to effect their own "spontaneous" recoveries.

    I do not want to be cut off from harmless but helpful products I have found beneficial.

    Check out this 10-minute teaser of Shawn Buckley, LLB, president of the Natural Health Products Protection Association, talking about natural health product regulation in Canada.

    http://www.youtube.com/watch?v=l2LkBuWpwVQ

  • ME2

    4 years ago

    Booker

    Booker, any even half-competent writer could pen equally compelling shockers about mis-prescribing by physicians, but even if she/he could find somewhere to publish it, the whitewashing effort would be instantaneous, and I'll bet even lawsuits contemplated.

    My own mother was mis-prescribed a series of powerful drugs which eventually put her into long-term care and which lead to her death. The physician there discovered that all those years she was actually suffering from Diabetes!

    If you can't see that the Medical fraternity is simply protecting its turf, and is using putative health issues as a smokescreen, then you're not as astute a person as I've come come to regard you.

  • Booker

    4 years ago

    ME2

    Quote:
    If you can't see that the Medical fraternity is simply protecting its turf, and is using putative health issues as a smokescreen, then you're not as astute a person as I've come come to regard you

    Sorry, but that is conspiracy mongering, as well as misdirection. The issue being discussed (raised by RickW) was Bill C-51 and whether therapeutic claims for products should be disallowed if they are untrue. The astroturf campaign against C-51 by a particularly slimy supplement manufacturer is immoral and indefensible. It would be indefensible if it came from a Big Pharma company too.

  • Yammer

    4 years ago

    Reimbursement is not the problem

    The problem isn't that tax money for health payments get funnelled into drug companies, it's that they're getting an unfair advantage. I wouldn't call it corruption or collusion as much as old-fashioned thinking; that, if you have an ailment, you go to the doctor to receive a fancy treatment.

    I'm all for doctors, but not for a medicine-first mindset. (Actually, I learned this from my own kids' pediatrician, so not all doctors are prescription-happy.)

    For example, it's absurd that people buy stool softening medications, instead of eating a couple of prunes. But prunes aren't allowed to label themselves as a safe, effective treatment for constipation; that's a privilege currently reserved for drugs.

    It's also absurd for people not to be prescribed exercise, who aren't getting enough. It is probably the best thing you can do to prevent disease. Can't afford running shoes or a gym pass? Maybe there's a role for government and/or charities in alleviating that.

    Then health becomes a matter of all-round treatment and prevention, rather than just about looking after the profits of pharma.

    Speaking of which, why do drug companies need to make a profit? Pay generous salaries, invest heavily in R and D, sure... but profit? From sickness? I dunno.

  • mopled

    4 years ago

    Big Pharma rules the UK roost

    http://www.dailymail.co.uk/health/article-1022282/GPs-ordered-prescribe-statins-1-5m-patients-slash-heart-attacks-strokes.html

    GPs ordered to prescribe statins for 1.5m more patients to slash heart attacks and strokes

    Now that is a really interesting headline given that statins were made available over -the-counter in 2004. I guess the sales didn't amount to enough.

    "‘In addition to the lack of benefit and expense, statins carry a substantial burden of side effects.'

    These include abdominal pain, diarrhoea and nausea, with the most serious adverse reaction being muscle weakness in about one in 1,000 users.

    This can progress to a complete breakdown of muscle cells that can lead to kidney failure and death."

    I just wonder when Canadian physicians will
    get a similar recommendation,since the same drug companies push the same drugs here.

  • ME2

    4 years ago

    Booker

    Booker, your statement :

    "Sorry, but that is conspiracy mongering, as well as misdirection."

    ....could be applied to almost every topic we routinely deal with on Tyee re Corporate activities. Where DON'T we see conspiracies practiced by these crooks and thieves - most particularly Big Pharma - and our near helplessness in the face of them?

    After reading the site you offered re EmpowerPlus, which Health Canada and Big Pharma have chosen to be the poster-boy for their promotion of C51, I decided to do a bit of Googling.

    After doing so, I am singularly unconvinced that the claims made for it are wrong, and even moreso that it represents a threat to the mental health of users. Those issues were thoroughly examined in the Calgary court case, and I believe that judge was not stupid.

    Now, in the face of that, and now worried that similar evidence from users and some practicioners might win more cases, the drug establishment is simply going to change the rules via C51 to suit themselves. Yes, it's all about, and ONLY about, "turf".

    If that isn't a conspiracy, then I don't know what is.

  • RickW

    3 years ago

    A painful prognosis for big drugmakers

    http://us.ft.com/ftgateway/superpage.ft?news_id=fto050720082314572919

    Quote:
    Richard Girling, global co-head of healthcare at Merrill Lynch, says: "The problem is not so much the size of companies but the concentration and reliance on single products.

    "This has been exacerbated by a lack of innovation over the years," says Mr Girling.

    The pain will be felt acutely over the coming few years, as patents expire at an ever faster pace, with fewer new blockbuster drugs coming through to replace them.

    Is this the real reason for the apparent haste in enacting Bill C-51?

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