The provincial government's new drug review process could potentially include individuals with connections to the pharmaceutical industry in a move that has left New Democrat health services critic Adrian Dix troubled. In the past, the University of British Columbia's Therapeutics 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."
In an interview, Mr. Dix stated, "I don't think anybody who looks at the review of pharmaceuticals thinks we need more conflict of interest. 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," the critic 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, stating that "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."