[Ip-health] Public has little presence in PharmaCare talks

[Joana Ramos]

*http://tinyurl.com/64fd3u*

Public has little presence in PharmaCare talks

Alan Cassels
Special to Times Colonist (Victoria)

Wednesday, November 26, 2008

On Friday, B.C.'s PharmaCare program, the main government program that
provides pharmaceutical coverage for citizens, will be engaging its
"stakeholders."

It's always positive when public programs make the effort to consult
with the people who are most affected -- in this case, those who take
prescription drugs, or almost all of us.

As Health Minister George Abbott recently said: Public involvement
supports government's commitment to transparency and accountability."
Amen to that.

But if we look a bit closer at past consultations, we might want to hold
off any celebrations.

The last PharmaCare "stakeholder" event, back in July, was an adventure
in faux public involvement.

Getting together mostly drug industry people, folks from retail
pharmacies and the biotech industry, plus a smattering of people from
disease groups known to dine on pharma's dime to discuss the future of
PharmaCare was not just crass, but pathetic.

By all accounts, that consultation was stacked about four-to-one in
favour of the industry vs. the public interest, a situation so
unbalanced that a pair of researchers at the University of British
Columbia wrote to the ministry asking why more than 80 per cent of the
"stakeholders" were drawn from pharma's supply chain.

This plea for real public involvement had little traction. Not only is
the invitation list for this Friday's consultation secret, the meeting
will most certainly be stacked with the usual pharma lobby types and a
sprinkling of their paid friends from a variety of sectors to give it an
air of "balance."

The reason this is such an important issue is that any stakeholder
consultation so obviously biased will not actually be guided by the
public interest in the deliberations. The public wants affordable,
effective drugs and other treatments, without having to mortgage their
kids' futures.

What a stacked meeting full of drug company executives will deliver is a
whitewash -- in this case, likely an attempt to ram through a set of
recommendations from another horribly biased process, the recent
Pharmaceutical Task Force.

Earlier this summer there was a bit of a hullabaloo over the task force,
set up by the provincial government with strong representation from the
brand-name pharmaceutical industry, as well as academics and clinicians
funded by the industry.

The task force was ostensibly established to review the future of drug
coverage in B.C. It produced a report so bizarre that some of us were
left wondering what kind of pills the members were popping when they
wrote it.

Some suspect that what is being acted out in the task force charade is a
battle between the Ministry of Advanced Education and the Ministry of
Health. The advanced education folks, backed by the drug industry, are
trying to scuttle the discipline of B.C. PharmaCare, because it stands
in the way of oodles of high-tech jobs in B.C.'s biotech industry.

Among the task force's stinkier recommendations was one which said we
should scrap the one agency that has helped B.C. PharmaCare control
costs and make prescribing more rational: the University of B.C.'s
Therapeutics Initiative.

This small group of physicians and researchers have not only helped keep
B.C. from swerving into the path of the oncoming truck known as Vioxx,
the arthritis drug that was responsible for an estimated 50,000 deaths
in the U.S. alone. They have also been tossing a lifeline to B.C.
doctors who are often at risk of drowning in the pharmaceutical
industry's spin machine. So, we have a group of stakeholders -- which
consists of drug companies, their paid cheerleaders in retail pharmacy
and biotech, and their 'friendly' patient groups -- sitting down to help
the B.C. government decide the future of a $1-billion per year drug
plan. Sweet.

I suspect B.C. citizens won't be sitting down for this one. Maybe the
government can't understand how offensive such a biased "stakeholder"
consultation looks to the public, especially when there's so much at
"stake." We've got a well-managed drug plan in B.C. that is the envy of
the rest of Canada, with the lowest per-capita pharmaceutical spending
and some of the most generous coverage in the country.

Yet if we to allow PharmaCare's future to be dominated by the interests
of the pharmaceutical companies, we should be prepared to spend money
like drunken sailors as they do in Quebec or New Brunswick. If we spent
on par with those provinces, we'd be sending another $300 million per
year to the drug companies.

That's a lot of money -- and a huge prize for the drug companies -- and
the reason why the pharmaceutical companies and the biotech industry are
working so hard to convince the government that they need to infiltrate,
modify and contaminate B.C.'s drug plan decision-making in order to
"grow the knowledge economy."

Perhaps an election can help clear the air, letting the real
"stakeholders" have their say and decide if they want private interest
to dominate decisions around how to manage our public drug bill.

Alan Cassels is a drug policy researcher at the University of Victoria
and the author of The ABCs of Disease Mongering: An Epidemic in 26 Letters.


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Joana Ramos, MSW
Cancer Resources & Advocacy
Seattle WA USA
+1-206-229-2420
http://ramoslink.info/
www.bmtbasics.org
www.healthyskepticism.org