Does it force the pharmaceuticals to more transparency by a law?

Photo: Kirsty Wigglesworth Associated Press
For the sake of transparency, GSK already publishes the total amount that it has paid to physicians and health care organizations in Canada during the year.

The pharmaceutical giant GlaxoSmithKline makes the case for the Québec follows Ontario and adopt a law that would require drug companies and other medical technology businesses to fully disclose all are accurate as they pay to health professionals.


The Fédération des médecins spécialistes du Québec (FMSQ), however, believes that such a law would be unnecessary in Quebec given that the code of ethics of physicians of Québec supervises very closely the relationships they have with the industry.


Such a law is already in force in many european countries, Australia, Japan and the United States.


The Physician Payments Sunshine Act passed by president Obama, for example, requires pharmaceutical companies to declare and define all sums over $ 10 that they have granted to physicians to decide on a conference, serve on an advisory committee of the company, teaching in a continuing medical education program or attend a medical congress international.


In Ontario, the minister of Health has recently submitted a bill that would make public all the financial compensation received by the health professionals, including physicians, pharmacists and nurses, hospitals and other health care organizations, and medical associations, and patients, the manufacturers of drugs and medical devices.


The sake of transparency


After having welcomed the initiative of Ontario, GlaxoSmithKline (GSK) is now hoped that Quebec will proceed with his turn.


For the sake of transparency, GSK already publishes the total amount that it has paid to physicians and health care organizations in Canada during the year : be 943 000 $ in fees related to services of health professionals and 1 192 000 $ in funding to health care organizations in 2016.

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The framework of this voluntary disclosure overall, which was also joined nine other pharmaceutical companies, has been developed by the Association for innovative Medicines in Canada.


“The establishment by this lobby of the pharmaceutical industry, this system of voluntary disclosure does not allow to analyze the dynamics of conflicts of interest,” says Marc-André Gagnon, a researcher at the School of Public Policy Administration from the University of Carleton, Ottawa.


“Shine a light on these practices is quite necessary to have a certain monitor and avoid abuse. Maybe it won’t make a big difference because the practices are very specific to Québec in relation to the promotion of pharmaceutical physicians. But it is necessary to give these tools because the abuse may also take a variety of forms, such as “over-prescribing” — prescribing drugs to patients who do not need them — and the “malprescription”. “


Rules of ethics


The president of the Collège des médecins du Québec, Dr. Charles Bernard, says that his organization “has established rules of ethics and conduct to very severe to keep away the pressures of the pharmaceutical and medical practice and to safeguard the professional independence” of its members.


“In this domain, we are ahead of Ontario,” he says, like his colleague Dr. Diane Francoeur, president of the FMSQ.


“In our code of ethics, it is clearly specified since 2016 that the physician should not receive a commission, rebate or material benefit to a pharmaceutical company, with the exception of the customary thanks and gifts of modest value,” says Dr. Francoeur.

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She adds that ” all the doctors who have been involved in studies on a drug, or those who have served on an advisory committee — to contribute their expertise to determine how a new drug could take hold within the therapeutic arsenal already in place — need to declare their conflicts of interest “.


The industry may, however, continue to fund the continuing professional development of physicians and the congress, but his gifts are to be granted ” without restriction and may not be used to promote their drugs.”


“Is it that there are doctors who receive secretly the gifts ? It is by surveys that one could discover. But it must be very marginal as a practice in Quebec, ” says Dr. Robert, who also have no objection to adopting a law that would require that to be specified the names, amounts and reasons of a gift or a compensation.


The president of the College of physicians questions, however, about the legality of disclosing such personal information.

Shine a light on these practices is quite necessary to have a certain monitor and avoid abuse
Marc-André Gagnon, a researcher at the School of Public Policy & Administration, Carleton University

Precedence of the law


Lawyer specialist in the pharmaceutical world, Jean H. Gagnon confirms that the Law on the protection of private information in the private sector prohibits their publication.


“But if there is a new law that is passed and which said that there must be disclosure, this law will have precedence over the first. As for donating to a political party, for example, the names of persons may be mentioned, ” says he.

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In the opinion of the president of the FMSQ, ” we do not need to legislate to land these good practices in the office of doctors, because the code of ethics of the Collège des médecins du Québec is already doing the work. Does one really need to spend public funds to make a parliamentary committee, and legislation to give the impression that we are in fact more ? “


Jean H. Gagnon points out that such a law would not affect pharmacists, since the bill (no. 92), adopted last December, prohibits all benefits related to the sale of medications is provided to pharmacists by manufacturers, wholesalers, and intermediaries, such as chains and stores.


Such a bill “is not in [the] cartons [of the minister] currently,” affirméJulie White, director of the office of the minister of Health and social Services.


“That said, it is a measure that could be interesting. We’re going to follow what is happening in Ontario. “