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Focus_2016-02_February
Focus_2016-02_February
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THE DEATH of our drug safety monitoring capacity means more wasteful<br />
spending on drugs, and also that many more people will suffer and even<br />
die from the adverse effects of drugs—and that cost is incalculable.<br />
This is almost impossible to estimate but with<br />
dozens of FOI requests and efforts by government<br />
to stop releases, let’s say $125,000 to<br />
$150,000.<br />
• Settlements with Bob Hart, Ron Mattson,<br />
Malcolm Maclure, and Bill and Rebecca<br />
Warburton, modestly guesstimated at $250,000<br />
to $600,000.<br />
What does this add up to? Somewhere<br />
towards $10 million in public funds, though<br />
I could be way off (either way) on some of the<br />
staff time estimates and the settlements.<br />
But that is just the beginning of what this<br />
scandal has cost.<br />
For the bigger picture we’d have to consider<br />
all the delayed and cancelled research and<br />
evaluation projects that were either in progress<br />
or in the pipeline. If you dial things back to<br />
2011, PharmaCare had numerous drug safety<br />
evaluations in progress, looking at the safety<br />
of drugs for Alzheimer’s disease; smoking<br />
cessation drugs including Champix (considered<br />
so dangerous other jurisdictions in the<br />
world have stopped paying for it); Accutane,<br />
for acne (known to cause birth defects); antipsychotics<br />
(given to one-third of seniors in BC’s<br />
longterm care facilities in 2012/13); and new<br />
anticoagulants (very expensive drugs which<br />
are replacing Warfarin).<br />
The Alzheimer’s study has been completed<br />
but the government has yet to make a decision<br />
on whether to continue to fund these<br />
drugs, considered by most independent experts<br />
to be ineffective, and for some patients, intolerable<br />
and toxic. The three-year delay caused<br />
by the Ministry’s turmoil has meant three more<br />
years of profits for the companies and costs<br />
of probably $30 to $40 million for the taxpayer.<br />
Blood glucose test strips were also going to be<br />
re-evaluated but those studies were delayed<br />
for four years, meaning a waste of about<br />
$10 million per year, or about $40 million<br />
(new limits were placed on them in January<br />
2015). The cancellation of research on atypical<br />
antipsychotic use means both avoidable<br />
deaths each year plus other costs in the use of<br />
the drugs deemed toxic for many seniors, especially<br />
those with dementia—likely in the tens<br />
of millions.<br />
What are we up to now? It’s not a stretch<br />
to say that the cost of the scandal has been<br />
in excess of $100 million due mostly to delayed<br />
and cancelled research programs and halted<br />
policy changes.<br />
Perhaps the biggest frustration in this scandal<br />
is the sense of loss of what had been a worldclass<br />
capacity and willingness to evaluate drug<br />
safety in BC. With PharmaNet, our provincewide<br />
pharmacy database covering every<br />
soul in the province, we collect some of the<br />
most robust data in the country, meaning we<br />
can assess with a good deal of precision how<br />
well drugs are being tolerated. Yet with the<br />
ongoing chill over the Ministry, very few independent<br />
drug safety evaluations are being<br />
carried out. In fact the Research and Evidence<br />
Development branch at PharmaCare was<br />
destroyed and has never been restarted.<br />
So the math only goes so far in capturing<br />
the impact of this scandal.<br />
Is it acceptable that PharmaCare, a government<br />
agency that spends over $1.4 billion per<br />
year of public money on drugs, is overseen by<br />
a government with a chronic habit of siding<br />
with the pharmaceutical industry (and which<br />
receives political donations from them)? Is it<br />
acceptable that government has failed to revamp<br />
important evaluation studies that are measuring<br />
the population effects of the drugs it pays for?<br />
The loss to our health system—which I’m<br />
pegging at perhaps $100 million dollars—may<br />
some day be fully accounted for. The death<br />
of our drug safety monitoring capacity means<br />
more wasteful spending on drugs, and also<br />
that many more people will suffer and even<br />
die from the adverse effects of drugs—and<br />
that cost is incalculable.<br />
I admit that my back-of-the-envelope calculations<br />
may be wildly off, but let me ask you,<br />
dear readers: Do you have any data to help<br />
me make those calculations more accurate?<br />
Do you work in the Ministry of Health? Do<br />
you have any hard numbers I could put into<br />
my spreadsheet? More importantly, do you<br />
know who initiated the firings and why? Please<br />
contact me. Brown envelopes most welcome.<br />
Alan Cassels is a drug policy<br />
researcher and author in Victoria.<br />
He attended the press briefing<br />
in September 2012 when the<br />
scandal was announced to the<br />
world, and has been following<br />
the saga ever since.<br />
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www.focusonline.ca • February 2016<br />
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