The warning that people who forget history are destined to repeat it dates back to the 18th century. But don't tell B.C.'s health minister, Margaret MacDiarmid. Her government can't remember what's been happening over the last decade or so.
Let's begin with the history. In recent years, the drug industry has made a concerted effort to manipulate test results of its products.
According to a 2007 U.S. Senate staff report, "suppression of scientific views" and "corporate intimidation" by pharmaceutical companies are an increasing concern. And one area in particular has become a battleground.
Before a new medication can be licensed for public consumption, it must be evaluated in clinical trials. In Canada, these are often conducted by university researchers, and they're supposed to be completely objective.
But drug companies have developed ways to manipulate the results. The scope of the study may be narrowed to maximize the chance of a good finding. In some recent lawsuits, firms have admitted they subsequently promoted their products beyond the range of those studies.
And money plays an important role. Seventy per cent of clinical trials are funded by pharmaceutical firms. That confers a significant advantage.
Manufacturers can use this leverage to demand ownership and control of whatever data is produced. They may also claim the right to halt a trial at any moment. That means studies that aren't going well can be buried. The public is never informed.
Collectively, these techniques violate basic scientific principles. But many universities go along, because the process is a financial gold mine.
And the result? A recent survey by investigators at the University of Toronto sums it up.
Across a range of drugs, 85 per cent of clinical trials sponsored by the industry generated positive results. In comparison, those funded by government agencies were positive just 50 per cent of the time. A different survey found an even larger tilt toward industry-funded trials.
In one respect, there's nothing surprising about this. On average, it costs pharmaceutical companies $850 million to develop each new drug that comes to market.
As much again may be spent on marketing. That's an investment worth protecting.
What's perplexing is the failure of governments across the country to come up with an adequate response. And nowhere more than here.
Far from curbing the industry's ability to manipulate research, B.C.'s health ministry has given the pharmaceutical sector a larger role.
At first, industry representatives were invited to join a key advisory panel. They recommended stifling the province's only independent drug assessment agency at the University of British Columbia. Despite an onslaught of protests, the government complied.
Then they asked for a greater role in decision-making at the Ministry of Health. That has also been granted.
Conflict-of-interest guidelines have been changed so that people with ties to the industry can serve on the ministry's drug-benefit council. The council plays a role in deciding which drugs are included in the provincial Phar-macare program.
The ministry says council members must declare conflicts, and in some cases may be asked to recuse themselves. But why are they there at all?
One of the principal duties of any health department is to ensure the drugs we take are safe. Is that best accomplished by giving manufacturers more opportunities to put their thumbs on the scales?
No one disputes the essential role of the pharmaceutical sector in scientific development. There cannot be progress or hope for the future if research efforts are not fairly rewarded.
But like any other industry, drug manufacturers have a huge vested interest. It is essential their products stand up to rigorous and independent verification.
As things stand, the Health Ministry has fallen down in that task. History will be its own judge.
