Ontario is expected to announce plans to require pharmaceutical and medical device companies to disclose any payments made to doctors, health-care providers, or medical organizations. The legislation will force the companies to publicly report cash payments, free dinners, and any other benefits provided to pharmacists, dentists, doctors, and other
regulated health care professionals, as well as hospitals and other medical establishments.
If passed, the legislation will make Ontario the first jurisdiction in Canada in which the financial ties between pharma and medicine would be transparent.
Health Minister Eric Hoskins told the Globe and Mail that:
This is about empowering patients and giving them tools and information so that they can make better, more informed decisions about their own health care…t's important to have this level of transparency and accountability. It creates even more confidence in our health-care system.
How the Program Would Work
Dr. Hoskins anticipates that data collection for the purposes of public reporting will begin in 2019.
Information about payments made by companies would be posted online in a searchable database and be listed by the name of the health-care professional who received that payment. The onus to disclose the payments would be on the companies that produce brand name and generic drugs as well as medical devices.
The question of whether there would be a minimum amount needed for reporting would be sorted out in future regulations.
The proposed legislation is modelled, loosely, on the
Physician Payments Sunshine Act in the U.S., which obligates medical companies to reveal how they compensate physicians for things such as giving speeches, teaching continuing medical education classes, travelling to international medical conferences, and sitting on advisory boards.
Other jurisdictions including Japan, Australia, and a number of European countries have similar “sunshine laws”.
In Ontario, little is known about how money or other compensation (gifts, etc.) is given to health care providers by doctors, or about the value of such remuneration, known as “transfers of value”.
Dr. Hoskins told the Toronto Star that:
When these transfers of value take place they can have unintended consequences…his isn’t suggesting at all the transfers are inappropriate. It’s important that the value and nature of those transfers . . . be made transparent.
Increased Scrutiny
The proposal comes at a time when the pharmaceutical industry has been subject to increased scrutiny due to their role in the opioid crisis.
A study published recently in the American Journal of Public Health found that opioid manufacturers paid more than $46 million (U.S.) to doctors in the United States between 2013 and 2015, with one in twelve American physicians receiving some form of remuneration.
Earlier this year, the federal government ordered an external review of opioid prescribing guidelines after it emerged that one of the physicians who voted on the guidelines had received payments from opioid makers. The review ultimately concluded that the guidelines were scientifically sound, despite a flawed process for identifying potential conflicts of interest among panelists.
Reaction to the Proposed Legislation
News of the proposed legislation was received with generally broad approval. Nurses and doctors, a medical device industry group, and at least one pharmaceutical company are supporters.
Dr. Andrew Boozary, the head of Open Pharma, a group of doctors who have been campaigning for the provincial and federal governments to require disclosure of payments from drug companies to doctors, praised Ontario for taking the lead, saying
I think there’s been a big blind spot in our health system for a long time. This helps address that… “It allows us to gain insight into some of the interactions between the pharmaceutical industry and health-care professionals that we previously had no idea about.
Dr. Boozary hopes that Ontario’s move will help spur action both in other provinces and federally. Dr. Hoskins echoes these sentiments, and has stated that ideally Ontario’s action on this will “inspire” his counterparts.
We will continue to follow developments in this proposed legislation and will provide updates as they become available.
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