Health Minister Adrian Dix is putting the province’s money where his mouth is. Before last May’s election, the B.C. NDP promised to boost health research.
Dix has already given the Therapeutics Initiative $10 million over five years to fund drug research and related issues. The TI, based out of the University of B.C., conducts after-market studies to see if new medications perform as well in the real world as in clinical trials.
Dix has now committed a further $5 million to strengthen the ministry’s own research efforts. His intent is to refocus medical care around a more solid base of evidence.
What makes this initiative significant is that the B.C. Health Ministry possesses one of the largest medical-data archives in the world, with tens of millions of files reaching back 25 years.
An archive that size offers numerous opportunities for testing new forms of care. Currently, for example, women in remote areas who are experiencing a difficult pregnancy are often flown to a larger centre in case a caesarean section is required.
Yet it is now possible, through tele-health networking, to have an expert walk a local surgeon through the procedure.
That would certainly be much cheaper, and more convenient for the patient. But is it safe?
Fortunately, that question can be answered. What’s needed is a well-designed research project to show whether this is an appropriate use of tele-health technology.
The ministry’s archive is also a gold mine for researchers looking into the side-effects of drugs. For example, some chemotherapies for breast cancer threaten heart function. In the short term, that risk is managed by using other medications that help the heart retain its strength during the therapy.
But does that benefit remain in place permanently? Linking MSP billing data with Cancer Agency and other data can provide all the information needed to resolve the matter.
There is also the pressing issue of ever-more-expensive medications coming on line. Some can be life-saving, but others might be no better than existing drugs that are much cheaper. And here industry sales tactics come into play.
There are about 600 representatives of drug firms in B.C. whose job is to encourage physicians to prescribe their product. The TI has a staff of fewer than 30.
The ministry can overcome that mismatch only if it brings its unique database to bear. Facts speak louder than sales pitches.
That said, it shouldn’t be the sole responsibility of provinces to undertake this kind of work.
The federal Health Ministry licenses every drug for sale in Canada. Unfortunately, Ottawa takes the view that its only duty is to say if a drug is safe and better than a placebo. Affordability is not a concern.
That has to change. Canada’s provincial governments, individually, are massively outgunned by big pharma.
While Dix is retooling his own ministry, he needs to convince his colleagues across the country that a collective effort is the only way to break down the industry’s advantage.
Recently, the federal government announced that an expert panel would be set up to look into a national pharmacare program. This might not be mission impossible, but there are huge obstacles.
Far better to form a national consortium that would conduct the kind of research Dix has in mind, but on a larger scale. This would strengthen bargaining power, and enable Ottawa and the provinces to reject drugs that don’t offer value for money.
That said, Dix has put his finger on a critical issue. We cannot always wait on others to provide the necessary answers. His ministry must take the lead if we are to keep costs down and still provide first-class care.
