Global Affairs: Canada (wk#7)
http://www.cbc.ca/news/health/opioid-pain-philpott-mcmaster-university-purdue-pharma-drug-industry-conflict-1.4121956
In response to an article “ANALYSIS:Opioid conflict-of-interest controversy reveals extent of big pharma's ties to doctors”.
Financial ties between doctors, hospitals and the pharma field are widely accepted — but rarely discussed
By Kelly Crowe, CBC News Posted: May 19, 2017 Last Updated: May 19, 2017
A McMaster University committee put together and assigned to develop new opioid-prescribing guidelines for Canada’s doctors, in under review by the federal health minister, who ordered the review to be independent scientific.
The hand-picked experts who would be voting on the final draft of the guidelines were supposed to not have any ties to big pharma since the drafted guidelines were intended to help doctors make difficult decisions about opioid use for chronic non-cancer pain. These rules of no pharmaceutical influence were clear when McMaster’s Michael G. DeGroote National Pain Centre was awarded the 1/2-million-dollar grant from Health Canada in 2015.
As the assembled committee sat and argued about when doctors should prescribe the dangerous pills, everyone was under the impression everyone else in the room was free of industry ties, since they had to fill out conflict-of-interest declaration forms twice. However one of the voting committee had ties to drug companies that sell opioids, including Purdue Pharma, which manufactured OxyContin, one of the most notorious prescription opioid drugs.
Dr. Nav Persaud, another member of the voting committee, when the guidelines were published earlier this month, said he was shocked when he learned the news. "My understanding was that the declarations were going to be reviewed, and anyone with financial conflicts of interest was going to be excluded from the voting panel,” He said. However, Dr. Sol Stern, a family physician based in Oakville, Ont., was somehow allowed to vote on the committee, even though he properly disclosed he had received financial compensation from Purdue and other companies that market opioids for the talks he would give and for serving on company advisory boards.
The aspect of Canada’s health-care system that is widely accepted, but rarely discussed has been labelled a ‘messy grey zone’. This aspect being the vast financial relationship between doctors, hospitals and the pharmaceutical industry. With 6 of 13 pain specialists on the broader expert advisory committee also disclosed ties to drug companies that make opioid pills.
Dr. Benedikt Fischer, a senior scientist at Toronto's CAMH, says the drug industry's influence through medical education or unrestricted grants is subtle and hard to pin down.
"The industry sponsors a range of things that look beneficial, which, at the same time, may form a situation of bias that can be hard to pinpoint, but may influence people's thinking and interpretation of critical data," he said. "A lot of it happens in a messy grey zone."
For me, I think if you want a committee with a varied stance on the subject, you are going to be hard-pressed to find a pro-opioid professional without ties. According to the numbers it seems to be the way things are. However the grant was contingent on ‘no ties to pharma’, and therefore someone or persons deliberately went against those rules, which is wrong. Also this makes me challenge the whole idea of doctors being able to prescribe drugs that they will get paid for prescribing. The knowledge of their involvement should have to be disclosed to the patients at the very least, however I think if someone is a rep, they shouldn’t be able to prescribe. There should be more checks in place to ensure integrity. It’s not like doctors don't make good money and need the honorariums etc. This system leaves our medical professionals wide open to temptation. Is this an extreme stand-point? yes, is it necessary? I believe so. I think if so much money from pharma companies wasn’t so involved, more naturopathic medicines and practices would be more commonplace and widely accepted, rather than being ‘muscled out’ by pharma’s.
