Ten of Canada's largest pharmaceutical companies have revealed that together they spent at least $48.3-million on payments to physicians and health-care organizations last year, a voluntary disclosure that critics of Big Pharma say falls well short of genuine transparency.
The figures provided a peek into how drug makers compensate this country's physicians for consulting, delivering speeches, sitting on advisory boards and travelling to international medical conferences.
But the companies did not name any of the doctors, nor did they reveal the total number of physicians they paid or the amounts they provided to doctors for running clinical trials.
Even though the disclosures had been planned for two years, only four of the 10 companies provided figures for all of 2016.
One provided information covering just three months.
The minimal disclosure shows the federal government needs to step in and force the pharmaceutical industry's hand, according to the Toronto doctor behind Open Pharma, a pro-transparency campaign.
"Allowing pharma to go with self-regulation or their own voluntary measures has left us really far behind," said Andrew Boozary, a resident physician at St. Michael's Hospital.
"I can't see anybody really celebrating this as a progressive leap forward."
Federal Health Minister Jane Philpott told reporters in Ottawa on Tuesday that she was sympathetic to that position, but that any move to force the disclosure of payments to individual doctors should be left to the provinces.
"Absolutely, in principle, I think this is an important concept," Dr. Philpott said.
"I know that some provinces are moving in this area and it's a conversation that I'm open to having, but obviously I can't wade into the [provincial] territory of regulating health professionals."
Pamela Fralick, the president of Innovative Medicines Canada, which represents brand-name drug companies and co-ordinated the voluntary disclosures made on Tuesday, stressed the revelations were only a first step.
"We know that the information that's out there is not going to be satisfactory to everyone," she said. "But it starts opening the doors a bit."
The drug makers released totals of their spending in three categories: Payments to health-care providers for services such as speaking and consulting; funding to health-care organizations such as hospitals; and funding to health-care providers to support their travel to international medical meetings and conferences.
Only 10 of the 45 members of Innovative Medicines took part in the voluntary effort. Each posted figures to its own website, and not always in an easy place to find.
Those companies are: AbbVie Corporation; Amgen Canada Inc.; Bristol-Myers Squibb Canada; Eli Lilly Canada Inc.; Gilead Sciences Canada, Inc.; GSK Inc.; Hoffmann-La Roche Limited (Roche Canada); Merck Canada Inc.; Novartis Pharmaceuticals Canada Inc.; and Purdue Pharma (Canada).
Of the companies that revealed a full year of data, Merck spent the most: just more than $9.4-million, most in direct payments to health-care providers. The drug maker spent a little less than $7.1-million last year paying physicians and other providers to act as consultants, advisers and speakers on its behalf.
Roche Canada was next, spending nearly $8.6-million on the three categories in all of last year, followed by AbbVie ($6.4-million); Amgen ($5.8-million); and Novartis ($4.9-million), each of which reported figures for July to December, 2016. Eli Lilly divulged figures for October, November and December.
Among companies that published a full year of data, GSK spent the least – a little over $2.1-million, none of it on sponsoring travel or paying physicians to speak to other prescribers.
"In my view, [the disclosure] is not good enough, but it's a good first step," said Paul Lirette, the president of GSK Canada (formerly GlaxoSmithKline,) which led the push for voluntary disclosures. He urged every life-sciences company in the country to join the voluntary program.
When it comes to transparency in pharmaceutical payments, Canada lags behind the United States, Australia and some European countries where patients can search for doctors' names on a public database to see if they have taken money from the drug industry. Some in the Canadian industry hope the voluntary disclosure will help persuade the government not to pass legislation compelling them to reveal more details.
Ms. Fralick of Innovative Medicines said that as things stand in Canada, drug companies would have to obtain consent directly from doctors before publishing the payment details – that is the main reason the drug makers elected to release only aggregate figures, she said.
Ms. Fralick said more of the brand-name companies are expected to disclose their total payments next year.
But Matthew Herder, the director of the Health Law Institute at Dalhousie University, said more aggregate disclosures will be useless without specifics.
"Transparency isn't a goal in and of itself. It has to be for some larger purpose," he said. "It's really about trying to affect change in the way medicine is practised."
With a report from Laura Stone in Ottawa