Canadian Drug Companies Conflict of Interest in Clinical Practice Guidelines

Summary of the Globe and Mail Article The pressure of Big Pharma

  • Financial conflicts of interest are commonplace on guideline committees; 46% of the panelists involved in nine guideline documents received funding from companies that might benefit from a positive mention of their drugs
  • In 3 cases, more than 75 per cent of the panelists declared a conflict
  • In 2 cases, the guidelines were financed directly by the pharmaceutical industry.
  • Doctors rely on guideline panels; official clinical practice guidelines can have a dramatic impact on how drugs are prescribed.
  • Canada has no nationwide rules for conflicts of interest; guideline committees set their own conflict standards.
  • Pharmaceutical companies pay doctors to deliver speeches, act as consultants, teach continuing medical-education courses, fly to conferences and spearhead clinical trials, among other services.
  • The United States Physician Payments Sunshine Act compels companies to divulge all payments of $10 or more to doctors; Canada has no requirement for drug companies to divulge payments to doctors.

This table shows drug company funding for the panelists writing guidelines for specific medical conditions.

Medical Guideline Percentage of Panelists who received funding from drug companies
Chronic Hepatitis C 100%
Acne Management 91%
Rheumatoid Arthritis Management 75%
Anxiety Mangement 59%
Hypertension 51%
Prostate Cancer 32%
Youth ADHD 25%
Colon Cancer 22%
Dementia Treatment 0%

Regarding the Rheumatoid Arthritis Management Guidelines, the two most expensive and widely used drugs in the category cost on average $27,300 and $15,800 a year, according to the federal body that regulates drug prices in Canada. Sales of drugs to treat Rheumatoid Arthritis, which are also used to treat other conditions, almost doubled between 2010 and 2015. They now account for more than 10 per cent of all public drug-plan spending in the country.

Read the entire Globe and Mail article June 20, 2017.