Panel Debates Thorny Issue of PHARMACEUTICAL FUNDING

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by Anne Rochon Ford

Should those engaged in research, service and action on women's health ever accept funding from drug companies? And if so, under what conditions? As individuals and groups making these tough decisions, what factors should we take into account?

In an era of shrinking public funds and unremitting needs, there are no easy answers to these questions. To give a full airing to the diverse views held on this issue, the National Network on Environments and Women's Health (NNEWH) organized a panel discussion last spring. NNEWH is one of one of five Centres of Excellence set up by the federal government in 1996 to do research on women's health.

Cosponsors of the event included DES Action Canada, the Institute for Feminist Legal Studies at Osgoode Hall Law School (York University) and the Toronto Women's Health Network.

Moderator Carol Kushner, author and health policy analyst, launched the discussion by pointing out that where we stand on these questions often largely depends on where we sit.

The following are excerpts from the four panelists.

Barbara Mintzes

"One of the main goals of the women's health movement -- the prevention of the medicalization of women's normal life experiences -- runs counter to the ethic of the pharmaceutical industry which is primarily concerned with the sale of its products. Why does the industry support community groups in their activities? Because it enables the company to spread awareness of their product in a pre-launch phase, it provides a more credible endorsement of the product than if it were coming from the company alone, and groups can aid industry in arguing for fewer controls on drug licensing and practice. Companies usually support groups that are likely to use their products -- for example, manufacturers of fertility drugs support infertility groups, makers of antidepressants support mental health groups etc. . . . There is public confusion about industry-sponsored events and programs: When is it education about health and when is it promotion of a drug?"

Barbara Mintzes is a graduate student in epidemiology in Vancouver and active with Health Action International.

Joel Lexchin

Commenting on the relationship between the pharmaceutical industry and the medical profession

"The industry doesn't really care if you associate a particular drug with their company. What the sponsoring of continuing medical education does is set up an atmosphere that says to doctors: "The pharmaceutical companies are your friends -- you can rely on them -- they do all these nice things for you." So, in other situations where there is more of a direct sell, this gift-giving on the part of the industry creates an expectation that there will be reciprocation by physicians -- so that when their sales rep comes to your office, you're going to listen to them. . . .If the industry is paying most of the money for medical research, what does this say about what can be researched? For example, if you're interested in infertility, are you going to ask: "How can we prevent sexually transmitted diseases that can lead to infertility? -- and expect to get funding?" Probably not. You're going to ask: What drugs can we look at that will help treat infertility once it has developed?"

Joel Lexchin is an emergency physician in Toronto and author of several publications on the pharmaceutical industry in Canada.

Darien Taylor

"Pharmaceutical money is relatively easy to secure with respect to turnaround time and follow-up reporting. This means that staff are free to spend more time providing direct service to women. I would characterize Voices of Positive Women's approach to pharmaceutical funding as being informed by the AIDS movement rather than the women's health movement, which often -- and rightly -- challenges the industry to provide better safety assurances to consumers through increased pre-market testing. Our approach has developed out of the specifications of our disease; we are increasingly marginalized and require multiple interventions to maintain our health and security. We are happy to take money from drug companies and turn it into Vitamin C for women with HIV and AIDS."

Darien Taylor is a founding member of Voices of Positive Women, a Toronto-based grassroots organization for women with HIV/AIDS.

Harriet Simand

"We feel it is a conflict of interest to take money from companies that have done harm to women's health. The pharmaceutical industry has at least an ethical -- if not legal -- responsibility to do the work that DES Action has done all these years -- to notify the population exposed to DES [diethylstilbestrol] about potential problems, ensure that DES-exposed persons are being properly monitored, and carry out ongoing research on our health needs and concerns for the future. Sadly, the industry has done none of this. DES Action is trying to provide an independent voice not only for the DES-exposed but also for others affected by harmful drugs. For this reason, we do not accept money from the pharmaceutical industry."

Harriet Simand is founder of DES Action Canada.

A booklet is being prepared that will further explore the issues raised during the panel discussion and provide guidelines to assist individuals and organizations making decisions about accepting pharmaceutical funding. It will be available in English and French and should be ready sometime in the fall of 1997. If you'd like to receive a copy, please contact Anne Rochon Ford at NNEWH.
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fax: (416) 736-5986.