As Ontario prepares to kick off consultations on forcing drug makers to divulge their payments to physicians, advocates for more openness in medicine are calling on Ottawa and the other provinces to step up and make transparency a national goal.
On Friday, Premier Kathleen Wynne's government will begin hearing from health-care providers, pharmaceutical-industry leaders, patient groups and others about whether the province should pursue a sunshine law similar to those in the United States, Australia and several European countries, where patients can search online to discover how much money their doctors have received from drug companies.
Ontario is the first province to take a serious look at crafting such legislation.
Matthew Herder, the director of the Health Law Institute at Dalhousie Univeristy in Halifax, lauded the province for exploring the idea, but said sunshine legislation would be much more effective if enacted at the national level.
An Ontario-only law "would be piecemeal transparency," said Dr. Herder, one of the experts invited to take part in the consultations. "It's just a very inefficient way to proceed. But I do think that if one place such as Ontario moves forward, it might help persuade others and, ideally, the federal government, to move on this."
Andrew Boozary, a resident physician in Toronto and the leader of Open Pharma, a transparency campaign that has garnered the support of prominent medical leaders, echoed that concern.
"It's great to see Ontario lead the way, but ultimately, we really believe this is an area where we need to see federal leadership," said Dr. Boozary, one of the physicians scheduled to speak at the summer consultations. "Patients in New Brunswick and British Columbia shouldn't have different access to [information] regarding conflicts of interest and transparency in their system."
Ontario's consultations are getting under way a month after the Canadian branches of 10 large pharmaceutical companies voluntarily disclosed that together they had paid physicians in this country more than $48-million in 2016 for work such as consulting, delivering speeches and sitting on advisory panels.
The companies released aggregate figures, not the details of payments to individual doctors, which led some critics to dismiss the effort as little more than an attempt to ward off mandatory disclosure.
On June 20 – the same day the companies published their aggregate numbers – Ontario Health Minister Eric Hoskins announced his government would be consulting on a potential new law over the summer.
Jane Philpott, the federal minister of health, said at the time that although her government is looking into how it might facilitate more transparency, action would be best left to the provinces. Her spokesman reiterated that position Thursday.
Dr. Hoskins was not available for an interview, but a document provided by his office laid out some of the questions the consultations expect to tackle, including what advantages or unintended consequences might flow from making payments public.
Participants will also be asked what kinds of health-related companies should be required to disclose, what the minimum dollar amount for a disclosed transaction should be (it's $10 in the United States) and which kinds of recipients should be included, assuming the province decides to pursue a new law at all.
Pamela Fralick, the president of Innovative Medicines Canada, which represents brand-name drug makers, is scheduled to speak on the first day of the consultations in Toronto Friday. She said she'll be in "listening mode" because her organization received only a week's notice about an appearance in the middle of the summer.
David White, the president of the College of Family Physicians of Canada, which represents 35,000 general practitioners, said his organization came out in support of Dr. Boozary's Open Pharma campaign last month because "people, including patients, have a right to know about what their physicians are receiving from drug companies."