Ontario to require disclosure of pharma payments to health professionals

TORONTO — Wide-ranging legislation introduced Wednesday by the Ontario government will require public disclosure of payments that pharmaceutical companies make to doctors, increase inspections for splash pads, barber shops and nail shops, and license medical device operators who use X-ray machines, CT scanners, and MRIs.

The bill was introduced Wednesday afternoon by Health Minister Eric Hoskins, who said it will make province’s health care system “more efficient and more transparent” for patients. If passed, the bill will modernize 10 pieces of legislation, the government said.

The bill would change existing rules for paramedics, who by law can only transport patients to hospital following a 911 call. The new rules, if passed, would allow paramedics to transport a patient to a non-hospital setting, like a mental health facility.

The legislation would change the safety inspection program for the province’s long-term care homes with new enforcement tolls that would include higher fines.

Public health regulations around recreational water facilities like splash pads and wading pools and rules for personal service settings like barber shops and nail salons, will be clarified under the regulations and make enforcement easier, the government said.

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The bill would also tighten up rules and enhance enforcement around community health facilities which operate medical radiation devices like X-rays, CT scanners and ultrasound machines. Ultrasound operators would also be more strictly regulated.

The most high profile piece of the act introduces mandatory reporting from pharmaceautical companies and medical device manufacturers make to health care professionals.

“It gives them tools and information that they can then use to make more informed decisions about their own health care, so I believe it’s something Ontarians want and deserve,” Hoskins said in an interview Tuesday.

“We are the first jurisdiction in Canada to undertake this, so I think that that leadership by Ontario is important on an issue that I think resonates with all Canadians.”

The province consulted over the summer with patient groups, health-care providers and the pharmaceutical and medical device industries about payments such as speaking engagement fees, paid meals, and travel expenses.

The legislation would require disclosure of the payments and create an online, searchable database of that information.

Ten major pharmaceutical companies released data earlier this year showing they had paid nearly $50 million to Canadian health-care professionals and organizations last year.

Drug company GlaxoSmithKline — one of those 10 companies — is supportive of the legislation.

Ethics and compliance officer Annie Bourgault said the company may, for example, pay a doctor to participate in a consultation meeting to speak about patient needs when GSK is about to launch a new medication.

“At the end of the day it’s for the benefit of the patients, so there’s kind of no downside to being transparent,” she said.

Payments from pharmaceutical companies to health-care providers can raise concerns about conflicts of interest in the prescribing and promotion of certain drugs.

But Hoskins said introducing legislation shouldn’t imply that the government believes there are negative connotations to such payments.

“What we want to do is … present information so that patients and health providers and the industry can have a better understanding of the nature of the transactions that are taking place.” 

There are already some restrictions in Ontario on the types of benefits that can be received, but disclosure isn’t always required.

A policy from the regulatory body for doctors in the province says physicians must not accept compensation from the pharmaceutical, biotechnology and medical device industries in exchange for meeting with promotional representatives, and they must not accept personal gifts.

They can, however, accept items such as teaching aids that benefit patients, under the College of Physicians and Surgeons of Ontario’s policy. They can also accept drug samples.

Doctors are allowed to accept compensation at “fair market value” for presenting at industry-supported continuing education events, sitting on advisory or consultation boards, and for participating in industry research.

The Ontario Medical Association has said it hoped any changes to disclosure rules would be applied to all health-care professionals to ensure doctors are on a level playing field. Hoskins said Tuesday it would apply to all regulated health professions in the province.

But many of the details, such as the minimum payment that would trigger the disclosure requirement, will be left out of the legislation and decided through regulations.

“We had a substantial consultation over the course of the summer and there was clear and broad support for the direction that we’re taking and the support for this proposed legislation,” Hoskins said.

“We’ll have that opportunity as we go forward … to continue the dialogue and continue the consultation and learn from other jurisdictions, but also hear from stakeholders.”

Patients in the United States, Australia and some European countries can already go online to see how much money their health-care providers have received from pharmaceutical companies.

Allison Jones, The Canadian Press