Lexchin Joel
School of Health Policy and Management, York University, Toronto, Canada.
Faculty of Medicine, University of Toronto, Toronto, Canada.
Int J Soc Determinants Health Health Serv. 2025 Jul;55(3):352-367. doi: 10.1177/27551938251325801. Epub 2025 Mar 17.
Patient groups play an important role in health care. At the same time, the majority of Canadian groups receive payments from pharmaceutical companies, which calls into question whether they speak for the best interests of their membership or the companies that fund them. Canada lacks any mandatory reporting by either patient groups or pharmaceutical companies regarding payments between groups and companies. There are three potential sources of information on the topic of payments: () declarations made by groups when they file submissions to the Canadian Agency for Drugs and Technologies in Health, an organization created and funded by Canada's federal, provincial and territorial governments, about whether the agency should recommend public funding for the new drug; () patient groups' websites; and () voluntary disclosures by pharmaceutical companies on their websites. This study investigates the data available in all three sources and finds that they are incomplete and inconsistent, making any conclusions about patient groups' conflicts of interest and funding unreliable. Although increased transparency is no guarantee of independence, it is an important and necessary first step. However, relying on voluntary disclosure is not sufficient. Legislation, such as the bill passed in the province of Ontario but never implemented, mandating disclosure by companies of payments that they have made is necessary.
患者群体在医疗保健中发挥着重要作用。与此同时,大多数加拿大患者群体接受制药公司的资金,这让人质疑它们是否代表其成员或资助它们的公司的最佳利益发声。加拿大缺乏患者群体或制药公司关于群体与公司之间资金往来的任何强制报告。关于资金往来这一主题有三个潜在信息来源:(1)群体在向加拿大卫生药品和技术局提交材料时所做的声明,该局是一个由加拿大联邦、省和地区政府创建并资助的组织,声明内容是关于该机构是否应建议为新药提供公共资金;(2)患者群体的网站;(3)制药公司在其网站上的自愿披露。本研究调查了所有这三个来源可得的数据,发现这些数据不完整且不一致,使得关于患者群体利益冲突和资金的任何结论都不可靠。虽然提高透明度并不能保证独立性,但这是重要且必要的第一步。然而,仅依靠自愿披露是不够的。立法,比如安大略省通过但从未实施的要求公司披露其已支付款项的法案,是必要的。