Receiving the 2005 Michener-Deacon fellowship gave me the gift most freelancers dream about – time. After experiencing a strange, yet serious adverse drug reaction myself in 2001, I became interested in writing about the complex system that takes our drugs from the lab, to the clinical trial, to the market-place. The more research I did, the more intrigued I became by the close ties between our public regulator, Health Canada, and the drug industry.
I wanted to let the public know what I had learned about Canada’s drug safety system and the fellowship bought me the time to dig deep into the subject. And it did take time. In the summer of 2005 I filed several Access to Information requests with Health Canada, asking for details on various components of their drug safety system, such as reports from inspections of drug companies and figures on how much money is spent defending lawsuits from pharmaceuticals. I had assumed much of this information would be easy to obtain. This was not the case.
While I waited for this information, I read stacks of reports and meeting minutes, and spoke with some of the leading thinkers on drug safety. I had the opportunity to leave my base in B.C. and do in-person interviews in Toronto, as well as attending a drug safety conference there that was aimed at guiding the industry through this post-Vioxx world.
Finally, in the spring of 2006, I had corralled most of the information I had requested from Health Canada -or at least what they were prepared to give me. The fellowship’s funding gave me the freedom to wait for these overdue information requests without being derailed by a strict deadline.
Over these months I learned that Health Canada does seem surprisingly geared towards serving the interests of the drug industry. When asked at the end of an interview if they had anything to add, one Health Canada higher-up wanted to stress again the improvements they had made on speeding up drug approval times. Health Canada is criticized for referring to industry as “clients” and this concept is clearly a part of its culture.
It is easy to pull up figures on how Health Canada has improved efficiency on drug reviewing. It is much harder to find any evidence it has improved drug safety. In fact, most initiatives geared to do so have been stalled since the change in government.
The drug industry provides about 20% of the budget for the Health Products and Food Branch, the umbrella agency that handles natural health products and prescription drugs. User fees from drug companies also make up more than half the funding of the Therapeutic Products Directorate, the branch that decides what prescription drugs to allow on the market. The industry also provides 60% of the budget for the department that is supposed to police the industry, including making sure they follow good manufacturing practices and report dangerous drug reactions. I found these figures shocking.
While the funding alone is not an issue per se, the drug industry also has a particularly close relationship with Health Canada. They meet regularly. The industry contributes input on the future of their fees. The group representing Canada’s pharmaceutical companies even suggested that it should help educate Health Canada’s drug reviewers about the latest science, a proposal that outraged drug safety advocates. When I last checked, Health Canada was considering the offer.
Each component of our drug safety system is extraordinarily complex. Investigating this system is a lot like lifting open one of those painted Russian dolls that has another doll inside – each is interconnected, yet separate. This fellowship gave me the chance to keep lifting.
Colleen Fuller, founder of the Vancouver-based consumer group PharmaWatch says the public has been largely left out of the drug safety equation in Canada and we must start fighting for our place.
“Certainly the amount of influence and power that the drug industry has in Canada has to be confronted by Canadians,” says Fuller. “This is a matter of public safety, not just for ourselves but our children, our parents, future generations. This is a big, big question that has to be addressed by the Canadian people.”
Drug safety is an issue that all Canadians should care about. We’re all going to need a prescription, if not today then tomorrow. Unfortunately, thousands of us will have a nasty reaction to our medication, and some of us will die from it.
January 8, 2007