The provincial government's new drug review process could potentially include individuals with connections to the pharmaceutical industry in a move that has left critics troubled.
In the past, the University of British Columbia's Therapeutic Initiative was responsible for conducting the scientific work that informs the government's decisions on which drugs PharmaCare should cover.
The initiative's conflict of interest guidelines state its "members and their immediate families shall have no direct or indirect financial interest in the company sponsoring an application or trial."
The government has now given other groups and individuals a chance to compete for that work, which ensures taxpayer dollars aren't wasted subsidizing drugs that don't provide good value for British Columbians.
But successful bidders won't necessarily have the same ethical standards as the initiative.
According to the government, "individuals who declare possible conflict of interest information are not automatically excluded from participating in the drug review process."
A subcommittee of the government-appointed drug benefit council will "select the best reviewer without conflict of interest whenever possible."
But that subcommittee may "select a reviewer with an identified conflict of interest after weighing the potential benefits and risks of including the participant in the review."
New Democrat health critic Adrian Dix said the government is taking the wrong direction.
"I don't think anybody who looks at the review of pharmaceuticals thinks we need more conflict of interest," he said.
"The BC Liberal government is alone in taking that position - that what we need, what's really required is more conflict.
"The Therapeutic Initiative has done an outstanding job and, as the government's discovering, an outstanding job in a very cost-efficient way," he continued.
"So what the government is proposing is a more cumbersome, less cost-efficient process, more prone to conflict of interest. And they're trying to argue that's a good thing. It's not."
But a government spokesperson defended the province's conflict of interest guidelines.
"Eliminating every participant in the review process (whether it be a physician conducting a clinical practice review or patient advocacy group providing input on a proposed drug for example) that has any conflict of interest could eliminate the best resources.
"In some cases the [council's subcommittee] may decide that the conflict is not relevant or that there is no expertise available that is free of conflict. In other cases, the reviewer may have a conflict for one assignment and not the next. So, a case by case application is essential."
The spokesperson also stated, "The approach is not new, is consistent with government policy, and is in line with other jurisdictions."
Nevertheless, drug policy researcher Alan Cassels countered.
"If a million people believe a stupid thing, it's still a stupid thing," he said.
"You see this all the time in medicine where those who are conflicted think it's just good enough just to declare your conflict of interest and somehow it's all above board."
"It's kind of like saying there are two members of the jury who are related to the defendant and we're declaring that interest so let's carry on as usual. That's exactly what it's like," he explained.
"We're fooling ourselves that we're actually serving the public when we allow this kind of thing to happen."
Sean Holman is editor of the online provincial political news journal Public Eye (publiceyeonline.com). He can be reached at [email protected].
