Big Pharma wins, B.C. taxpayers lose

The government's pandering to Big Pharma by killing a world-acclaimed initiative that ensured only effective drugs were covered by Pharmacare is truly appalling. The Therapeutics Initiative saved the health system hundreds of millions of dollars while ensuring good medical outcomes.
There is no public policy reason to eliminate it. But it also hurt pharmaceutical company profits — B.C. spends much less on prescription drugs than the national average — and they have lobbied for more than a decade to kill it.
Finally, they've won, as this piece reports.
Pharmaceutical companies have a great economic incentive to sell more drugs, at higher prices. That's their job. And it's worth a lot to them to win this kind of victory, so they can spend a great deal on the campaign - political donations and PR campaigns and support for groups that will support them. (Most illness advocacy groups - heart, stroke, cancer - received significant support from drug companies. Some likely couldn't survive without the money.)
Health consumers and taxpayers have to rely on government to look after their interests. It's not working.

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One small step that could help is a government-funded Consumers' Health Forum, which I wrote about in the Sun in 2004.


Health care consumers need a voice

VICTORIA - The only people who haven't got a say in the way health care works in Canada are the patients.

Doctors have the BCMA. Nurses, the BCNU. Drug companies have their lobbyists and funded health groups.

But you and I, the people who rely on the system to keep us healthy and fix us when things go wrong? We have no voice.

The government, you might argue. But you'd be wrong. The government doesn't represent health care consumers. It balances a broad range of pressures.

When Health Minister Colin Hansen is locked in a struggle with Nanaimo emergency room doctors, for example, his government represents not just parents who might need to bring a sick baby into emergency at 2 a.m., but businesses that want lower taxes and people pushing for other spending priorities. He's mindful of patients' interests; he's also mindful of the commitment to a balanced budget.

Nothing wrong with that. Just don't interpret it as government representing consumers.

There's a knee-jerk reaction against talking about consumers in the context of government services. But that's what we are -- we pay an average $2,700 a year each for health care, and we consume the service. And we're especially powerless because we're dealing with a monopoly supplier and can't shop elsewhere if we're dissatisfied.

The absence of any real consumer voice has created a vacuum, allowing special interest groups to claim to speak for us. It's obligatory for everyone in a health care debate to talk about putting patients first, while pursuing their own interests.

The Cancer Advocacy Coalition weighed in last week with its annual report linking higher spending on cancer care with lower death rates. The title, Your Money or Your Life, summarizes the message. B.C. has the highest per-capita spending on cancer, the report found, and the lowest mortality rates and shortest waiting times for treatment. More money equals lives saved.

Perhaps. But perhaps B.C. has a lower cancer death rate because people are generally more active and healthier here, or because of tougher anti-smoking rules, or because of a large immigrant population less predisposed to cancer. A true consumer organization would look at all those factors, and weigh the effectiveness of using the same money for other health priorities.

The cancer coalition is doing important work. But it doesn't speak for consumers. Its stated goal is to make cancer the No. 1 health care priority in Canada, not to advocate for better health care.

And like virtually all major health advocacy groups, the cancer coalition depends on funding from big pharmaceutical companies.

Alan Cassels, a drug policy expert at the University of Victoria, says the drug company funding inevitably creates conflicts. "You can almost see the influence of the money."

The problem is compounded because when Health Canada sets out to hold high-level consultations, these are the groups it calls to the table. Each advances its special interest; no one speaks for us.

It's not a uniquely Canadian problem. But fixing it need not be costly or difficult, as Australia has shown.

The Consumers' Health Forum of Australia is almost 20 years old, formed with government support after consumers demanded a health care voice.

It's a coalition of health and community groups. Only organizations that represent consumers -- not providers or care workers or corporations -- are eligible.

The forum represents the public, takes complaints, publishes articles and newsletters, and, most importantly, speaks to the government on behalf of the consumer.

All for about $750,000 a year from government and a bit more from members -- no drug company donations -- and with a staff of eight.

It's a small price to give consumers a long overdue voice.