What needs to change in the Canadian pharmaceutical industry

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ICYMI: What needs to change in the Canadian pharmaceutical industry

SHAREThe year’s headlines pointed to shocking rates of opioid addiction and death, looming drug shortages, class-action lawsuits, fears over climbing drug prices, and concerns about the cozy relationship between drug makers and health-care providers.

“The opioid crisis in many ways is a symptom of a larger problem in the pharmaceutical sector. There are many ways to trade in bias in scientific evidence and then organize marketing campaigns based on selective studies,” said Marc-Andre Gagnon, an associate professor at Carleton University who studies pharmaceutical policy.4,588 Canadians died of opioid-related overdoses,

Purdue, a family-owned company, filed for bankruptcy in the U.S. this fall but under a proposed agreement, will set aside $10 billion to $12 billion for lawsuits. The company is to be restructured as a public beneficiary trust, with the Sackler family giving up any ownership. The proposed settlement also stipulates that addiction treatment drugs being developed by the company would be given to the public for free and any future profits would go to plaintiffs.

No matter the final tally when all the lawsuits are settled, some experts don’t expect the fallout from the opioid scandal will change much in the industry. Quinn Grundy, an associate professor of nursing at the University of Toronto, says the kneejerk reaction to the crisis has been that opioids are bad, without players in the health-care system taking responsibility for their role in the problem. She says many others, including regulators and front-line practitioners, were complicit.

“At least two companies had a position they euphemistically called vice-president in charge of going to jail,” said Lexchin, who is a professor emeritus at York University. “It’s all factored into the prices of drugs and the sales strategies.” But the real issue around drug shortages is in the supply of generics, which have much lower profit margins than brand names, said Lexchin. About 75 per cent of all prescriptions are filled with generics, but they account for just 25 per cent of overall spending on drugs.

Canada ranked third among the 31 countries of the Organisation for Economic Co-operation and Development when it comes to drug prices, at about 25 per cent above the median in 2016, the most recently available numbers. Canada was also third when it comes to drug spending per capita at $1,043. “Physicians don’t have access to the full data and the drug companies still choose what to publish,” said Lexchin. “They don’t say anything about negative results.”

Gagnon also points out the new rules are not retroactive, so there are plenty of drugs out there that could still be problematic. He said forecasted spending for the fiscal year 2019-2020 is “approximately the same” for the scientific review process to assess the safety, efficacy and quality of drugs before they come to market and the post-market monitoring to ensure safety once they are being prescribed.

Mediator’s maker, Servier Laboratoires, and the drug regulator are now on trial for manslaughter, fraud and other charges in a case expected to take months to resolve.

 

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