Amy sancetta/The Associated Press
International experts issued a strong plea on Wednesday for continued government support of the province's one-of-a-kind, independent drug review panel, currently on the Liberals' chopping block.
Proponents said the Therapeutics Initiative has saved lives and hundreds of millions of dollars with its rigorous scrutiny of new drugs, before they are added to the province's list of approved prescriptions.
"I cannot speak too highly of the Therapeutics Initiative," said Dr. Sidney Wolfe, a member of the drug safety committee of the Food and Drug Administration in the United States and head of the Public Citizens' Health Research Group.
"When you consider the massive amounts of money spent by companies to convince doctors to prescribe their drugs, the TI's role in educating doctors and pharmacists to make evidence-based decisions is invaluable."
Headquartered at the University of British Columbia, the TI operates at arm's length from government, the pharmaceutical industry and other vested interests.
This has resulted, generally, in a more cautious approach to approving expensive new drugs that are speedily embraced elsewhere.
Many point to the TI as one reason B.C. has by far the lowest per-capita spending on prescription drugs in Canada. Last year, the province spent an average of $518 a person on prescriptions, compared with the overall Canadian figure of $680.
Jerome Kassirer, editor of the prestigious New England Journal of Medicine from 1991-99, said recommendations by the Therapeutics Initiative over the years "have made a heck of a lot more sense than American [drug recommendations]" which are often driven by pharmaceutical companies.
Dr. Kassirer pointed to a series of cholesterol-reducing drugs that were recommended by a U.S. review panel but assessed by the TI as having no added benefit over existing medication.
A majority of the U.S. panelists had a close relationship to the industry, he noted, and the TI's assessment was subsequently shown to be right.
"Their evaluation of drugs is independent and free of conflict of interest. … Americans were seeing their recommendations through green-coloured glasses," said Dr. Kassirer, referring to the influence of profit-driven drug interests.
The two prominent American doctors were hooked up by telephone at a news conference organized by NDP health critic Adrian Dix. Well-known British clinical pharmacologist Andrew Herxheimer was also billed to call in, but technology failed.
Mr. Dix was motivated by the government's decision to dramatically reduce the TI's role and open up B.C.'s drug review process to a much wider array of academics and clinicians.
At the same time, the government has made no firm commitment to maintain the $1-million annual grant to the TI to help keep it running.
The new policy follows recommendations by a 2007 pharmaceutical task force, including several representatives of the drug industry, that called for an end to the TI's pivotal role in approving drugs for the province's formulary.
Mr. Dix charged the government is "putting private interests ahead of the public interest. What we have here [the TI]is something of extraordinary value, which is seen as something remarkable by people around the world. But the Liberals are out to weaken it, and that's very disappointing."
He referred to the TI's assessment of the drug Avandia, hailed as a breakthrough treatment for Type 2 diabetes when first approved for use in the U.S. in 1999.
But shortly after Avandia went on the market in Canada, Dr. James Wright of the TI sounded an alarm, citing worrisome weight increases and a seeming rise in the frequency of angina and heart attacks among those using the drug.
As a result, the drug was prescribed less in B.C. than elsewhere, a decision that undoubtedly saved lives, since a recent study obtained by The New York Times found 304 deaths linked to the use of Avandia during the third quarter of 2009.
Avandia is currently the subject of fierce debate within the U.S. over future use of the drug.
"The Therapeutics Initiative has been right on so many drugs over the years," Mr. Dix said. "It's a critical counter-balance to the most profitable industry in the world."
Health Minister Kevin Falcon was unavailable for comment, but an e-mailed statement issued by his ministry said the new drug review model is designed to provide "improved clinical advice, increased transparency and more timely information."