drug company dollars come with side-effects

Drug-company dollars come with side effects
By Pieta Woolley

http://69.90.47.35/straight.co m/content.cfm?id=11655
Publish Date: 21-Jul-2005

Normally, when there's a change in B.C.'s health care, there's always a
critic eager to tell the other side of the story. But when health
minister George Abbott announced on July 11 B.C.'s funding for access
to the breast cancer drug Herceptin, nary a contrary voice was heard
among the kudos.

Part of the reason for the hush, explained Sharon Batt, a bioethics
doctoral fellow at Dalhousie University, could be that drug companies
fund Canada's supposedly independent patient advocacy groups, whose job
is to speak out on behalf of Canadians.

"All we're hearing is that this is great, and that kind of bull***,"
Batt told the Georgia Straight in a phone interview from Halifax. She
characterized news coverage of the drug as "emotional", featuring women
in tears. "It's not that it's [Herceptin is] not useful, but it's not a
major advance."

There's reason to be wary of Herceptin, according to Batt. In a 2000
paper-presented at a York University biotechnology conference-that
criticized the drug, Batt argued that the enormous cost to government
health budgets of providing Herceptin, estimated at about $50,000 per
patient, will cause other Canadians' care to be compromised. Plus,
studies showing the long-term effectiveness of the drug, she said, have
not been thoroughly reviewed.

Patient advocacy groups could point this out. But, according to Batt's
analysis, along with Pharmawatch Canada and other organizations, some
patient groups have become nothing more than part of a thinly veiled PR
wing of the big pharmaceutical companies. That's why there's the
uncritical hush, she said.
Pharmaceutical funding of health groups is not new news; in the U.S.,
criticism of the practice is widespread. Most Canadians, however, are
unaware of how widely drug-company dollars are spread among local
organizations.

It's quite common for Canadian pharmaceutical companies to fund
health-oriented, nonprofit groups. For example, the B.C. Persons With
Aids Walk for Life 2005, planned for September 25, is sponsored in part
by pharmaceutical companies Shire BioChem, GlaxoSmithKlein,
Bristol-Myers Squibb Canada, Boehringer Ingelheim, AnorMED, and Pfizer.
Donations from Bristol-Myers Squibb Canada also reach the Positive
Women's Network, the BC Centre for Excellence, Vancouver Native Health,
and the Dr. Peter Centre in Vancouver. Pfizer Canada donates to the
Rick Hansen Man in Motion Foundation, the Canadian Diabetes
Association, and the Arthritis Society.

It's not that patient groups are morally bankrupt for taking the
money-it's that there's only so much non-pharmaceutical funding out
there from which they can draw.

The solution, according to Colleen Fuller, the chair of the
Vancouver-based nonprofit industry watchdog PharmaWatch, is for the
government to adequately fund advocacy groups so they don't have to
rely on industry support. In the1950s, when societies such as the
Canadian Diabetes Association were established, advocates were needed
to criticize government. Now, she said, they're needed even more to
criticize multinational pharmaceutical companies.
What's a patient group to do if they don't receive any, or enough,
government funding, though?

"They've [pharmaceuticals have] got lots of money, and if we can access
it, we can provide a lot of services," Paul Lewand, the chair of BCPWA
told the Straight in a phone interview from Vancouver. He said he is
grateful to the pharmaceutical companies for the funding BCPWA
receives. "But the downside is that we have to always be aware. The
danger [of allowing them influence] is that we would no longer be
providing true, unbiased health information."

Lewand knows all about this tension. Last year, the society rejected
$30,000 in pharma-funding from Abbott Laboratories when the company
jacked up the price of a protease inhibitor by 400 percent in the
United States. The group only subsequently accepted the donation when
the company later explained it made allowances for low-income
Americans. He also notes that although pharmaceuticals are an important
part of BCPWA's funding (between five and 10 percent; the government
funds about 50 percent of the budget), pharmaceutical companies are not
welcome to advertise in Living +, the nonprofit's magazine.

Even closer to the forefront of the debate is the B.C/Yukon chapter
of the Canadian Cancer Society. The nonprofit is the first CCS chapter
in Canada to review its corporate donation policy, according to CEO
Barbara Kaminsky. It's not only an issue of real conflict of interest
but also of whether or not the public perceives the BCYCCS to be in
conflict. Already, it has a policy against tobacco sponsorship; it may
also in the future exclude companies that make unhealthy food, and
perhaps even pharmaceuticals. So far, the BCYCCS only has a draft of
its new policy, which it wouldn't share with the Straight.

The BCYCCS is partly funded by the provincial government to the tune of
$1.1 million a year, and Kaminsky says government funding is a model
that works well.

"I met with Gordon Campbell recently," Kaminsky told the Straight. "The
premier said he had no problem with us being critics of his government.
He said it's a difficult job, and we do it well. I thought that was
heartening."

Still, compared with Breast Cancer Action Montreal, B.C. groups have a
long way to go. In 2001, the advocacy group became one of the first
health organizations in Canada to reject all pharmaceutical funding.

The San Francisco chapter of BCA took the lead in establishing a
no-pharmaceutical sponsorship policy. In addition, Women and Health
Protection, a national umbrella coalition of health advocacy groups and
activists, refuses pharmaceutical funding. Not so coincidentally,
Herceptin-critical Batt is on the steering committee of WHP.

If traditional patient advocacy groups aren't taking a hard line on
drugs such as Herceptin, Batt suggests a new grassroots approach:
genome-jamming, named along the lines of Vancouver-based Adbusters'
direct-action strategy called culture-jamming, which encourages
creative public protest. She is frustrated that the underside of
Canadian drug policies are so infrequently presented.

Because crying cancer patients on TV don't tell the whole story about
the impact of health-care decisions, perhaps Batt's radical strategy of
pharmaceutical critique would serve as a counterpoint.
Georgia Straight

http://www.straight.com/sectio n.cfm?id=172

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