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ANDREA DEMEERFeb. 14, 2018 9:44 a.m.

Critics say voluntary move falls short of any real transparency

By Kelly Crowe, CBC News Posted: Jun 20, 2017 9:38 PM ET Last Updated: Jun 21, 2017 11:31 AM ET

Canadians were given a glimpse at the millions of dollars doctors receive each year from pharmaceutical companies, when 10 of the country’s largest firms voluntarily disclosed the figures online. But critics are decrying the lack of details around those numbers. (Joe Raedle/Getty Images)

CBC News/Health
Kelly Crowe

For the first time, Canadians have been given a glimpse at the millions of dollars doctors receive from pharmaceutical companies each year — though critics say the move stops far short of true transparency.

Ten of Canada’s largest drug companies voluntarily released information about how much money they give physicians, posting the disclosures to their websites Tuesday. The participating companies were:

•AbbVie Corp.

•Amgen Canada Inc.

•Bristol-Myers Squibb Canada

•Eli Lilly Canada Inc.

•Gilead Sciences Canada, Inc.

•GSK Canada (GlaxoSmithKline)

•Hoffmann-La Roche Ltd. (Roche Canada)

•Merck Canada Inc.

•Novartis Pharmaceuticals Canada Inc.

•Purdue Pharma Canada

But the companies did not disclose specific names, nor did they list the reasons for the payments. Some companies disclosed data for three months, others chose six months, and four disclosed payments for one year.

It was a disappointment for those who have been calling for greater transparency in the pharmaceutical industry.

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The amount they’re asking for is way, way, way over what is justified … We, as a government, will not pay one dollar more than what was justified.”— Gaétan Barrette, April 1, 2016.

Quebec’s health minister, notorious for his tough talk and his tight grip on hospital finances, was adamant he would not yield to the private consortium suing the government for $330 million.

Led by engineering firm SNC-Lavalin, the consortium claimed it was owed that sum (which it later hiked to $360 million), on top of the $1.3 billion it was to be paid under a contract to build the superhospitalof the McGill University Health Centre. The contract — known as a public-private partnership — was supposed to guarantee that any cost overruns would be shouldered by the private partner and not taxpayers.

Yet less than two years later, on Jan. 8, the government announced it reached an out-of-court settlement with the consortium, agreeing to pay it an extra $108 million. That same day, Quebec declared an even bigger payout, $125 million, to settle a dispute with a different consortium that built the nearly $2-billion CHUM superhospital.

What the government did not reveal that day is that it concluded yet another financial settlement arising from the $939-million expansion of Sainte-Justine Hospital. That project was not built as a public-private partnership, and instead the government assumed the full risk of all cost overruns.

So what was the amount of that settlement? No more than $9 million, the Montreal Gazette has learned.

The irony of the settlements — a staggering total of $233 million for the private consortia tasked with keeping a lid on costs compared with a $9-million hit for the government in a project in which it took the full risk — is not lost on critics of public-private partnerships.

“Despite cost overruns, the government maintains better control over (construction) projects than the private consortia,” said Guillaume Hébert, an expert in public-private partnerships (PPPs).

To read more, click on:

http://montrealgazette.com/news/local-news/superhospital-public-private-partnerships-are-costlier-than-ever-critics

Essays October 2016

Open Letters

David J. Price

This letter is part of series of Open Letters from Canadian leaders in Healthcare. To see the complete series please click here. 

As a family physician, I’m used to hearing intimate details of a patient’s life experience and after thirty years in this profession, there aren’t too many things that surprise me. And while I know that it shouldn’t surprise me, it still does when someone I’ve just met at a social function, on realizing that I’m a physician, proceeds to tell me the most intimate details of their recent medical ailment.

Lately however, I often hear more about their medical journey within the healthcare system. Although many include comments about how wonderful their own family physician is, too often I hear tales of frustration about the system within which their family doctors works. It often amazes me what patients will put up with. Anecdotes such as: “When I phone my doctor’s office I’m on hold for twenty minutes before I can speak with a receptionist”, “I seem to be asked the same question over and over again” or “when I phoned to have my sick baby seen, I was told that the next available appointment is in 10 days” are not uncommon. It’s amazing what we all will put up with from a system that hasn’t kept pace with advances in knowledge and technology, [all of which has enabled us to live longer, albeit often with multiple chronic diseases.]

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Global News – Health

February 9, 2018 2:02 pm

By Richard Zussman

Online Journalist based at B.C. Legislature  Global News

B.C. Health Minister Adrian Dix has announced changes to the
PharmaCare system.

THE CANADIAN PRESS/Darryl Dyck

The B.C. government is eliminating PharmaCare deductibles for families with net annual incomes between $15,000 and $30,000.

The move comes as part of a $105-million pledge over three years, with money that will also be put towards reducing the deductible on prescriptions for families that bring in between $30,000 and $45,000 per year.

“No parent should have to make the difficult decision between their family’s health and putting food on the table,” said Health Minister Adrian Dix.

“I have looked at the PharmaCare program for a long time and the need to address the question of deductibles have been an impediment in the ability of people to adhere to drug programs.

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OPINION

Retired physician shares his views in our series, The Fentanyl Fix, solutions for B.C.’s opioid crisis
By Gabor Maté, for CBC News Posted: Feb 03, 2017 4:53 PM PT Last Updated: Feb 03, 2017 4:53 PM PT

Dr. Gabor Maté is a retired palliative care doctor. (Gabor Mate)

OPIATES SOOTHE EMOTIONAL PAIN

The drugs these users choose are often opiates, the most powerful painkillers we know.

In my years as a palliative care physician, I daily had reason to be grateful for the easing of suffering the opiate medications afforded my patients afflicted with cancer and other pain-inducing conditions.

But opiates also soothe emotional pain; in fact, the suffering of psychic pain is experienced in the same part of the brain as that of physical pain.
Hence, the first question when dealing with opiate-dependent human beings should be not “why the addiction” but “why the pain?”

Dr. Gabor Maté, who worked as a physician on the Downtown Eastside for 12 years, says we need to recognize addiction, not as a failure of will but as a complex response to suffering.

What engenders such unbearable pain in human beings that they would knowingly risk their very lives to escape it?

The answer is trauma: deep, unresolved trauma that imposes a lifetime of suffering, fear of reality, isolation, hopelessness and an urgency to alter one’s experience. This is where addiction comes in.

“The meaning of all addictions could be defined as endeavours at controlling our life experiences with the help of external remedies,” wrote the psychiatrist Thomas Hora.

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SOHC is one of the founding members of a newly established Provincial Network called the BC Rural Health Network.

The BCRHN consists of healthcare advocacy organizations from rural towns, working to improve healthcare service delivery in rural BC.

Our goals include the following:

• share successful strategies in an effort to address rural healthcare concerns
• advocate for policy changes that provide all rural residents with attachment to a health care practitioner
• identify areas of research aimed at improving access to healthcare in rural communities and to provide fertile ground for research to take place
• inform the BC Ministry of Health of rural healthcare concerns and recommend solutions for the improvement of services to rural BC residents
• develop partnerships with other provincial organizations in an effort to influence policy changes that improve access to healthcare services
• recognize the healthcare concerns of indigenous communities and include their issues and concerns as part of our work
• improve access to mental health services
• promote patient-centred, community-based primary healthcare reform

Membership includes organizations from the communities of Ashcroft, Hornby & Denman Islands, Nelson, Sicamous, Slocan Valley, South Shuswap, Trail, and Princeton. Membership is open to any organization that supports the purpose and goals of the BCRHN.

website: https://bcrhn.ca

facebook: https://www.facebook.com/bcruralhealthnetwork

twitter: https://twitter.com/BCRHNetwork

CANADIAN FOUNDATION for HEALTHCARE IMPROVEMENT (CFHI)

To read the full report, please visit http://www.cfhi-fcass.ca/Libraries/Reports/Primary-Care-Strategy-EN.sflb.ashx

‘Toward a Primary Care Strategy for Canada’

From the summary:

PRINCIPLES OF PRIMARY CARE TRANSFORMATION

Aims and vision, however clear and compelling, are not sufficient by themselves to bring about system transformation. A thoughtful approach to the change process is also crucial. As primary care transformation proceeds at the provincial, regional and local levels – with appropriate federal support – what principles should guide the change process? We suggest the following:

◥ Strict adherence to the principles of universality and access to care based on need.

◥ An unwavering focus on public benefit, as opposed to professional or private interest

◥ Meaningful engagement of patients and citizens in system design (person-centred system design).

◥ Application of an equity lens to health services planning and measurement.

◥ Attention to the health and healthcare needs of communities and populations as well as individuals — in particular socially disadvantaged and high-needs communities and populations.

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