British Columbia And Its ‘Bizarre’ Task Force Report
6 CommentsBy Ed Silverman // May 23rd, 2008 // 12:11 pm
In an effort to keep a lid on rising prescription-drug costs, the health ministry in Canada’s British Columbia convened a special task force to examine the process by which the provincial government agrees to cover medications through its Pharmacare program. And the results, which the government accepted, are drawing criticism.
Of the many recommendations (here’s the report), one particular notion is being counterproductive - scrapping the Therapeutics Initiative, an independent group that evaluates meds and issues reports to Pharmacare for coverage decisions.
The task force would like to ensure the watchdog group has no future role in coverage, a recommendation that Alan Cassels, a drug policy researcher affiliated with the School of Health Information Sciences at the University of Victoria, calls ‘bizarre.”
In an interview with the Canadian Broadcasting Corporation*, Cassels says the task force never addresses what he says is $40 million to $50 million in annual savings that TI generates by issuing its recommendations. “They’ve done a fabulous job of both educating physicians and really sort of making drug policy in BC more evidence-based and more reliant on facts,” he tells the CBC.
He and others have also criticized the provincial goverment because five of nine task force members have ties to pharma, such as task-force chair, Don Avison, who was touted as a lawyer with experience working for several ministries, although the announcement failed to mention Avison also sits on the board of LifeSciences British Columbia, a lobbying group that includes many drugmakers.
Although patient groups sometimes criticize Pharmacare for being too restrictive, Cassels cites TI’s cautious stance toward Merck’s Vioxx and Glaxo’s Avandia diabetes pill as examples of prudent, evidence-based decisions when compared with coverage recommendations elsewhere in Canada.
“The question is what are they putting in (TI’s) place and is it going to do as good a job as the TI has done?” Cassels says. “It’s good that we’ve got a group advising government on caution when it comes to new and expensive drugs…They need powers expanded, not reduced…If you’re getting rid of the one organization in the province (that provides independent advice) then, I don’t want to exaggerate, but you’re making it more dangerous to go into a pharmacy.”
* If you look at the programs for Thursday, May 22, the interview is the second one listed.
in BC
I do not know enough detail to comment on the TI and the recommendations here however the characterization of LifeSciences BC as simply a lobbying group is perhaps somewhat poor. Although it does lobby and represent for industry concerns both locally, nationally and internationally its more of a Biotech/BioPharma Community collective and has other activities (Networking, Employment, Career Support, News). Most other areas that have concentration of industry (SD, Bay area, Seattle, DC, Boston, NC) have similar organizations that would not classify in that manner either.
Q: Do you know why the Setting Sun is on the BC Flag?
A: So that the people who live there can see the Sun during certain times of the year…
Paul
Problem had been that the BC system had as its only goal cost reductions and going for the lowest-cost alternative. This was a mixed message at the same time as the government wanted to invite and encourage innovation. You can’t have it both ways, so it had to choose one path or another.
Justice in Michigan
TI is one of the most important sources of unbiased drug information we have. If it is killed, it will be a major victory for those who are threatened by the truth.
Single example of many. It was only through TI, working with Health Research Group, that we learned that the CLASS study published in JAMA left out half the data. Even Robert Temple was shocked.
This is a direct assault.
Jaynesday
Paul,
I am not familiar with the Canadian system but I take it from your comments that this evaluation method determines the design of drugs?
Paul
Jaynesday,
Not really. First drugs are discovered, tested, developed and approved to be effective and safe (at least appropriately safe for the condition and alternatives), without regards to one state, one province or one managed care organization has as its methods to approve for reimbursement. Companies try to satisfy general requirements, but it would be impossible to meet every single requirement from every single place.
Then come places like BC, who rely on what seems to be a scientific, balances source of information to cherry pick it and use it as a crutch to only pay for the cheapest possible alternative.
Basically, they say that if a VW can get you from point a to point be, they will never pay for anything more even if the Volvo is safer, faster, more reliable, more consistent, and has a longer life. Bottom line, VW is cheaper to get you from point a to point be and that’s all we care.
Thus the conflict between wanting to be a province that encourages innovation and investment, and wanting to be a province that doesn’t care about innovation and the fruits of investment. They had to make the choice, one way or the other.
Jaynesday
Paul
Thanks for the explanation.