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Embattled Pharma Review Panel Works Well: Top Scientists

Ministry's push to disband Therapeutics Initiative 'lacks substantive evidence.'

By Andrew MacLeod 17 Feb 2009 | TheTyee.ca

Andrew MacLeod is The Tyee's Legislative Bureau Chief in Victoria. You can reach him here.

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Health Minister Abbott: giving lobbyists a say.

The director of the Therapeutics Initiative said an academic review released last week shows the body needs more stable funding to do its job.

"Basically they're saying the activities we're doing now we're doing well and we should continue," said Jim Wright. "It's been extremely good value... The important thing is that the activities we've been doing have been helping the physicians and patients in B.C. and Canada and internationally."

The TI, based at the University of British Columbia, reviews the evidence on drugs and makes recommendations to the provincial government about whether or not it should pay for them.

The TI has been under threat since more than a year ago when a panel set up by Health Minister George Abbott recommended disbanding the body. The panel was stacked with people from the drug industry and one of the co-chairs was the head of a drug lobby group.

The academic reviewers found that panel's report "lacking in substantive evidence."

In contrast, last week's review was written, Wright pointed out, by "Very high calibre, internationally recognized people who don't have any conflicts."

The reviewers were UBC's Bassam Masri, Jean Gray at Dalhousie University, Lisa Dolovich at McMaster University and David Henry at the Institute for Clinical Evaluative Sciences in Toronto.

'Differently possessed'

"If there's a difference of opinion around the science I suppose that wouldn't be astonishing," said Abbott in an interview last week. "Scientists looking at others often are differently possessed."

The academic review doesn't undercut his task force's report, he said. "I think it's consistent with what the task force report had recommended, so we're looking very closely at the recommendations and moving forward with them."

There is still a need for the work the TI does, he said, no matter who does it. "The principle that still underlies all of this is we need to have a body that can look at the science around whether we should add pharmaceuticals to our formulary and I think, consistent with what we have concluded in the past, that's likely to be done out at UBC.

"I don't think anyone's ever said TI was a bad thing. I think what they've said is TI ought to be improved in terms of it's transparency of decisions and it's inclusiveness of people who could be part of the team. My read of the UBC report is it supports both of those assertions."

Drug policy researcher Alan Cassels, who at times has done work for the TI, said the academic review will displease people in the industry who want to see the TI scrapped. "They've put a lot of effort to try to discredit the TI," he said. "To do that takes a lot of effort and they want a payback for that effort... I'd say this report takes the wind out of their sails."

'Red is black'

NDP health critic Adrian Dix said Abbott is insisting on misreading the UBC review, which was not at all supportive of the task force's report. He called it the "ideology of cognitive dissonance" and said Abbott is "Pretending what's up is down and what's red is black."

Campbell and Abbott have facilitated an attack on the TI because their friends in the drug industry don't like it, Dix said.

"No industry has more influence with senior decision makers in the Campbell government than the pharmaceutical industry," he said. "They're huge contributors to their coffers and they in this case were able to force the government to put forward a task force on something that absolutely didn't need to be reviewed and that's the Therapeutics Initiative."

If the government were serious about protecting the TI from these kinds of political pressures, it would endow positions at UBC, he said. "Clearly a permanent source of funding should be maintained for the Therapeutics Initiative so it can do what it does, which is save lives and provide good advice to British Columbians."

The province spends over $1 billion on prescription drugs each year, Dix said.

For around $1 million a year, the TI reviews drug research and helps ensure the government gets good value for that money. "We have a small body here, proven to do a good job, proven to provide independent advice and proven to save lives... The pharmaceutical industry wants to even get rid of it and the Premier is facilitating that."

Program has international reputation

Wright said he's glad the academic review, which was completed in the fall, is now public. "There's a lot of irony in what's happening. Here you have a government funded project that's been very successful and developed an international reputation," he said. "You'd think the government would take some pride in it and continue it and expand it."

The review said the TI enjoys a much better reputation internationally than it does in B.C.

"This has certainly been helpful. It needs to come out in the press again and we need to put some pressure on the government to do the right thing," he said. "You've got something they should be putting up on a pedestal for people to see and than they have a task force that says one of the options is to scrap it."

Dix said the government's attack on the TI will be a "small but important" part of the debate about health care in the election campaign.

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