The NDP’s health critic has claimed that the B.C. Liberal government is stripping a world-renowned drug-research program of its central role in the province. Adrian Dix, MLA for Vancouver-Kingsway, told the Georgia Straight that the Therapeutics Initiative saves lives and money but that the pharmaceutical industry is successfully lobbying the provincial government to carry out a “vendetta” against the independent body.

Since 1994, the TI has been providing unbiased, evidence-based information on a wide variety of drug therapies. Via its concise “Therapeutics Letters”, physicians can learn about the effectiveness of the latest treatments for a wide range of conditions.

“They are getting rid of it because their political funders in the pharmaceutical industry don’t like its independence,” Dix argued. “We are going to essentially be lobbied into getting rid of it by an industry that is rapacious in its greed.”

On May 21, 2008, the B.C. Liberals announced that they would accept recommendations to replace or drastically reform the TI. Letters signed by physicians denouncing the move subsequently appeared in newspapers and journals across Canada, and watchdog groups and the Opposition cried foul.

Meanwhile, drug-industry lobby groups such as Rx&D maintain that the TI was contributing to the province’s historically negative track record on making new drugs available and that reforming or replacing the body will improve B.C.’s health-care system.

Health Services Minister Kevin Falcon declined to be interviewed for this story. Ryan Jabs, a spokesperson for the ministry, told the Straight that negotiations with UBC’s faculty of medicine are under way, and he conceded that when a new contract is signed, the TI’s funding will change.

Dr. Jim Wright, managing director of the TI, told the Straight that “ongoing issues” prevented him from answering questions on the TI.

The recommendations the B.C. government has said it is adopting were made by a panel called the Pharmaceutical Task Force, which was established by former B.C. minister of health George Abbott in November 2007. With a mandate to instruct the ministry on how it should reform B.C.’s PharmaCare program, the PTF suggested the TI be stripped of its two primary functions: drug-submission review and education.

The PTF was composed of nine clinical professionals, academics, industry leaders, and policymakers. Five of the nine had ties to the pharmaceutical industry at the time the PTF’s review of the TI was performed.

David Hall was a senior vice president of Angiotech Pharmaceuticals; Robert Sindelar was a board member for LifeSciences British Columbia, an industry lobby group; Sue Paish was chief executive officer of Pharmasave Drugs; Russell Williams was president of Canada’s Research-Based Pharmaceutical Companies (Rx&D), another lobby group; and the task force’s chair, Don Avison, was also a board member for LifeSciences B.C.

In November, Avison was hired by Pfizer Inc., the world’s largest drug company, as Canada’s representative on its international advisory board. Neither Avison nor Pfizer responded to the Straight’s requests for an interview.

From 2005 to the end of 2008, LifeSciences B.C.’s members donated more than $750,000 to the B.C. Liberal party, according to records at Elections B.C.

Alan Cassels, a drug-policy researcher at the University of Victoria, described the PTF as the equivalent of hiring experts supplied by the tobacco industry to instruct the government on how to regulate smoking.

“You had this stacked committee, and of course, they come out with some very predicable recommendations,” Cassels said in a telephone interview. “The base of it just didn’t pass the sniff test.”

Speaking from Rx&D’s headquarters in Ottawa, Williams noted that the pharmaceutical industry’s actions are regulated by conflict-of-interest guidelines and a code of ethics.

“What we’re trying to do is make sure that you get the right people making these decisions [on drug review],” he said. “And having different experts around the table is going to help British Columbia make better decisions.”

Williams emphasized that the PTF “consistently heard” that the TI confined its review of drugs to an insufficiently small community of experts. For that reason, it recommended the replacement of the TI with a new body with access to a wider array of professionals.

The provincial government recently moved forward on this point. A December 2009 Ministry of Health Services report on the implementation of a replacement body stated that resources have already been set aside for what will be called the Drug Review Resource Committee. According to that paper, membership is expected to be announced in January or February and implementation of the DRRC is scheduled to happen shortly thereafter.

“Patient groups and health-care professionals were asking for a better system, and that is what I would like to get out of it,” Williams said. “I think we’ll get an overall better process and better health-care system.”

Cassels argued the opposite, and pointed to a November 2008 review of the TI commissioned by the dean of UBC’s faculty of medicine. That group’s report was “absolutely glowing”, Cassels said, and suggested that funding for the TI be increased.

According to Cassels, the existence of the TI is one reason B.C.’s prescribing habits can be described as relatively conservative. He explained that every year, new drugs are heavily marketed by their manufacturers. As a counterweight to those multimillion-dollar advertising campaigns, the TI offers evidence-based reports that often advocate caution when prescribing new drugs.

Dr. Jim Thorsteinson, executive director of the B.C. College of Family Physicians, echoed Cassels’s words.

“We are all well aware that there is a huge amount—millions and, internationally, billions—of dollars that goes into the promotion of drugs,” Thorsteinson said. “And, at times, we find that the guidance we’ve had through that promotion has not ultimately proven to be well founded. Having unbiased, evidence-based information is a welcome resource for clinical practice.”

You can follow Travis Lupick on Twitter at twitter.com/tlupick.