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With the debate over pharmacare taking centre stage in Canada, an army of “experts” have been flooding the news and opinion pages of digital and print media to caution against a universal, single-payer drug plan.

They appear in Canada’s major outlets with quasi-academic titles such as “Senior Fellow” or “Affiliated Scholar” working at “independent” research institutes. But these supposedly impartial policy experts all have ties to Big Pharma and the insurance industry – the industries with the most to lose from a public pharmacare program. 

This exposé unveils the network of think tanks and commentators that have been doing industry’s bidding over the last two years – and will continue to poison the public debate as pharmacare legislation moves through the parliamentary process.

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Pharmacare’s corporate opponents are keenly aware that people in Canada see them as the least trusted voices about the health care system. That’s why they have spent decades building up an “intellectual echo chamber” of “like-minded” organizations to deliver key messages to policymakers and the broader public for them.

That list of organizations includes leading right-wing think tanks like the Macdonald Laurier Institute, the Montreal Economic Institute, and the Fraser Institute, as well as less crudely ideological organizations such as the C.D. Howe Institute, the Canadian Chamber of Commerce, and the Conference Board of Canada.

Big Pharma, insurance companies, and their lobby groups provide direct financial support to these think tanks, populate their boards of directors and policy councils, and have significant sway over the research they conduct.

Many of the echo chamber’s experts are also connected to Big Pharma’s main lobby group, Innovative Medicines Canada, via a pseudo-academic publishing enterprise called the Canadian Health Policy Institute.

Despite these glaring conflicts of interest, figures from these institutes have been regular sources of commentary on pharmacare in Canadian media.

In the last two years, as pharmacare was hotly debated, digital and print media ran 49 op-eds by scholars from these think tanks and cited their experts or their research 25 times, our research has found.   

None of these 74 articles disclosed the commentator’s financial ties with industry or other conflicts of interest.   

The primary objective of this echo chamber has been to sow doubt and confusion in the public debate. Rather than a mind-control machine, Big Pharma-funded think tanks are more like white noise generators that seek to drown out the facts in the policy discussion, reaching even the highest levels of policymaking.

Voices in the echo chamber have downplayed the severity of inadequate drug coverage in Canada. They have sneered at the idea that Canada’s drug prices – now second highest in the world, after the U.S. – are excessive. And they have revived “zombie arguments” against pharmacare – arguments that have been debunked and struck down time and again in previous rounds of debate.

Unmasking the deeply compromising ties between this cast of characters and their corporate patrons is now more urgent than ever.

The new Pharmacare Act, Bill C-64, dealt a major blow to pharmacare’s corporate opponents by laying the foundation for a single-payer universal program. But that victory is fragile, and the echo chamber has already cranked up the volume on their misinformation in response, which could derail progress on this once-in-a-generation expansion of our health care system.


More about the Canadian Chamber of Commerce

The co-chairs on the Chamber’s Life Sciences Strategy Council are Johnson & Johnson’s Head of Government Affairs & Policy (Lesia Babiak) and the CEO of a Pfizer-funded biotech incubator (Gordon Macauley of adMare Bioinnovations). Sun Life’s Vice-President (Government Affairs & Public Policy), Laura Hewitt, sits on the Chamber’s Board of Directors. 

On pharmacare, the Chamber’s position has echoed industry talking points, suggesting that a single-payer system would be costly and unrealistic, and that it would slow down and reduce access to drugs. 

The organization’s op-eds are penned by Kathy Megyery, who is the Chamber’s Senior Vice President and policy lead for the Life Sciences Council and a former pharmaceutical executive who worked as Sanofi’s Vice President of Public Affairs from 2006-2016.





PHARMA TIES: Unknown 
INSURANCE TIES: Canada Life (via Power Corporation) 

Widely regarded as the Quebec equivalent of the Fraser Institute, the Montreal Economic Institute (MEI) is a neoliberal think tank that has been involved in numerous campaigns to expand the role of private health care in Quebec and rest of Canada.  

Despite the organization’s obvious corporate ties, Canadian news media regularly cite research and opinion from the Montreal Economic Institute with no mention of its vested interests in the debate. In the last two years, experts from the MEI have penned five opinion columns opposing national pharmacare, and their research has been quoted in seven additional news articles.  

None disclosed the Institute’s sources of funding.



Index


In the last two years, as the Liberal-NDP supply-and-confidence deal put pharmacare at the centre of the political agenda, digital and print media ran 49 op-eds by scholars affiliated with industry-funded think tanks and cited their experts or their research at least 25 times. None disclosed the extensive ties between these scholars and their institutions and the pharmaceutical and insurance industries.  

Our search was limited to digital and print media (it excluded TV, radio, or podcast interviews) and covered the period beginning with the Liberal-NDP agreement in March 2022 up until May 2024.  

Below is a compilation of those articles. This list is not exhaustive.

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The Fraser Institute   

Op-eds: 

Canadians should decide what to do with their money—not politicians and bureaucrats” by Jake Fuss and Grady Munro, Winnipeg Sun, April 24, 2024  

Trudeau’s pharmacare plan would likely reduce drug coverage for millions of Canadians” by Kristina Acri, The Hill Times, March 14, 2024   

Trudeau government not being honest about true costs of national pharmacare” by Jake Fuss and Mackenzie Moir, The Hill Times, February 28, 2024. 

Will Ottawa’s fiscal update trim spending and debt? Don’t hold your breath” by Jake Fuss and Grady Munro, Financial Post, November 16, 2023   

The false promise of pharmacare” by Catherine Swift, The Niagara Independent, October 20, 2023    

National pharmacare likely won’t help Canadians who need it the most” by Bacchus Barua and Jake Fuss, The Hill Times, September 20, 2023    

Provinces accept federal money at own peril” by Tegan Hill and Milagros Palacios, Toronto Sun, June 6, 2023   

Canadians wait much longer for drugs than Americans and Europeans” by Nigel Rawson and Bacchus Barua, National Newswatch, May 29, 2023   

Next week’s Trudeau budget will answer critical questions about Canada’s future” by Jake Fuss, Calgary Sun, March 22, 2023 

Four in 10 Canadians prefer socialism but not higher taxes to pay for it” by Jason Clemens and Steven Globerman, Financial Post, February 23, 2023 

Trudeau government preaches diversity yet practises homogeneity with national programs” by Jason Clemens, The Province, October 13, 2022 

“Government spending will come back to bite us” by Jason Clemens and Jake Fuss, National Post, August 11, 2022, FP12 

Trudeau’s zeal for centralization will cost Canadians dearly” by Jason Clemens and Jake Fuss, Toronto Sun, July 26, 2022 

Programs less popular when cost is apparent” by Jake Fuss and Jason Clemens, Winnipeg Free Press, May 30, 2022   

Scant support for Ottawa’s big plans — if they include tax hikes” by Jake Fuss and Jason Clemens, Financial Post, May 3, 2022 

Mentions:  

Liberals should be wary of costly pharmacare plan” by Lorne Gunter, Toronto Sun, January 6, 2024   

Free medications produce overall health-care savings in Ontario trial, new study suggests” by Bethany Lindsay and Christine Birak, CBC News, May 26, 2023    

Trudeau programs popular until we have to pay, says report” by Lorrie Goldstein, Toronto Sun, May 3, 2022  

We’ll all pay for PM’s promises, not just the rich — report” by Lorrie Goldstein, Toronto Sun, April 6, 2022 


Macdonald-Laurier Institute    

Op-eds:  

Chrystia Freeland delivers an equal mix of bad economics and bad politics” by Philip Cross, National Post, April 16, 2024   

Why Canada spends so much on health care and still has a crisis” by Nigel Rawson and John Adams, The Globe and Mail, March 6, 2024   

On this rarest of days, commit to support those with rare diseases” by John Adams, Beth Vanstone and Nigel Rawson, Financial Post, February 29, 2024   

Spend less on dental care and pharmacare, more on treatments for rare medical disordersby Nigel Rawson and John Adams, Financial Post, January 4, 2024  

Government hostility to biopharmaceutical industry reduces access to innovative drugs by Nigel Rawson and John Adams, The Hill Times, November 15, 2023  

Pharmacare won’t help Canadians with rare disorders” by Nigel Rawson and John Adams, Financial Post, November 7, 2023   

Liberals should reject the national pharmacare monopoly the NDP wants” by Aaron Wudrick, Financial Post, October 31, 2023   

The PMPRB has outlived its usefulnessby Nigel Rawson, The Hill Times, June 26, 2023  

Let’s hope turmoil at drug price review board portends end of outdated agency” by Richard Owens, National Post, May 21, 2023 

Lower drug prices are a good thing. Canada’s approach to achieving them was not by Nigel Rawson, The Globe and Mail, March 17, 2023  

“Drug prices review board no longer useful” by Nigel Rawson and John Adams, Financial Post, March 1 2023, FP8  

Suffer from a rare disorder in Canada? Good luck” by Nigel Rawson and John Adams, Financial Post, November 1, 2022 

Peak government is leading to reckless spending” by Ken Coates, Whitehorse Star, August 29, 2022 

“Federal coalition’s plans leading to reckless spending” by Ken Coates, The Lethbridge Herald, August 25, 2022, A6 

Canada should stop stealing from drug companies” by Richard Owens, Financial Post, July 20, 2022 

“The civil service’s massively big burden” by Ken Coates, Regina Leader Post, May 12, 2022, A7 

Is the public service up to managing the Liberals’ huge expansion of government?” by Ken Coates, National Post, May 8, 2022  

Those ‘working hard to join’ the middle class betrayed by Liberal budget contradictions” by Philip Cross, Financial Post, April 7, 2022    


Montreal Economic Institute    

Op-eds:  

Federal pharmacare could threaten your coverage quality” by Emmanuelle Faubert, Troy Media, March 8, 2024   

Alberta’s opting out of federal pharmacare just might save your coverage” by Krystle Wittevrongel, Edmonton Journal, March 6, 2024   

Federal pharmacare is a bomb waiting to detonate your coverage” by Emmanuelle B. Faubert, National Post, March 3, 2024   

The downsides to the NDP’s universal drug insurance plan” by Emmanuelle Faubert, Troy Media, November 7, 2023   

Pharmacare: More government could mean fewer drugs” by Emmanuelle Faubert, Hamilton Spectator, November 5, 2023   

Mentions: 

Pharmacare bill could slash prescription coverageSaskToday.ca, March 10, 2024  

NP View: Provinces should reject Trudeau-Singh socialized pharmacare schemeNational Post, March 2, 2024  

The pharmacare bill becomes the woebegone child of a loveless Liberal-NDP marriage” by John Ivison, National Post, February 29, 2024  

Here’s how politicians and advocates are reacting to Ottawa’s new pharmacare bill” by The Canadian Press, February 29, 2024  

Trudeau brings in substandard pharmacare to stay in power” by Tasha Kheiriddin, National Post, February 27, 2024  

Pharmacare will not jeopardize Canada’s fiscal standing, Freeland says” by Kristy Kirkup, Globe & Mail, February 25, 2024  

Diabetes medications, contraceptives to be funded by Ottawa as NDP, Liberals reach agreement on pharmacare” by Marieke Walsh, Kristy Kirkup, Globe & Mail, February 23, 2024  


Canadian Health Policy Institute   

Op-eds:  

“National pharmacare will reduce drug access for almost 26 million” by Brett Skinner, National Post, May 2, 2024 

Controlling drug costs doesn’t require pharmacare,” by Brett J. Skinner, Financial Post,   March 27, 2024 

Canada has in fact achieved universal drug insurance coverage” by Brett Skinner, Toronto Star, August 12, 2023   

New drug price controls are not evidence-based” by Brett Skinner, Financial Post, July 6, 2022 

Is drug price policy evidence-based or evidence-deficient?” by Brett Skinner, The Hill Times, July 4, 2022   

Mentions: 

Rush for diabetes and weight-loss drug Ozempic puts cross-border sales in spotlightThe Canadian Press, March 30, 2023 

As COVID-19 lingers, the need for national pharmacare progress is clear: experts” by Emily Putnam, Global News, December 23, 2022  

Experts call on Health Minister Duclos to rise to challenge of health-care system transformation” by Jesse Cnockaert, The Hill Times, April 24, 2023 


C.D. Howe Institute

Op-eds:  

Pharmacare bill offers too much ambiguity and too little ambition” by Chris Bonnett, The Hill Times, April 10, 2024   

Pharmacare cornerstone has been laid but where are the blueprints and budget?“ by Rosalie Wyonch, Financial Post, February 28, 2024 

How we can actually achieve national pharmacare” by Chris Bonnett, The Hill Times, September 13, 2023   

An update on national pharmacare, and five steps to get us there faster” by Chris Bonnett, HealthyDebate.ca, July 24, 2022   

Mentions:   

‘A lot of outstanding detail’ on pharmacare leaves program’s future riding on talks with provinces” by Ian Campbell, The Hill Times, March 1, 2024 

‘Goodwill’ remains on both sides in pharmacare talks, despite political pressures facing Liberals and NDP, say observers” by Ian Campbell, The Hill Times, November 29, 2023  

Here’s what the federal government’s tight fiscal outlook could mean for pharmacare” by Laura Osman, Toronto Star, November 23, 2023 


Canadian Chamber of Commerce   

Op-eds:  

An expensive plan that will make Canadian patients wait longer for fewer drugs” by Kathy Megyery and Pascal Chan, Financial Post, February 26, 2024   

A one-size-fits-all pharmacare program is a solution in search of a problem” by Kathy Megyery, iPolitics, October 10, 2023   

Mentions: 

Alberta to opt out of national pharmacare deal, demanding cash instead: LaGrange” by Lisa Johnson, Edmonton Journal, February 26, 2024  

Pharmacare will not jeopardize Canada’s fiscal standing, Freeland says” by Kristy Kirkup, Globe & Mail, February 25, 2024  

Diabetes medications, contraceptives to be funded by Ottawa as NDP, Liberals reach agreement on pharmacare” by Marieke Walsh, Kristy Kirkup, Globe & Mail, February 23, 2024  


Conference Board of Canada   

Mentions:   

Federal pharmacare could threaten your coverage quality” by Emmanuelle Faubert, Troy Media, March 8, 2024  

Editorial: Say ‘absolutely not’ to socialized drugsTelegraph-Journal, March 5, 2024  

There is no ‘pharmacare deal‘” by Chris Selley, National Post, March 3, 2024  

Federal pharmacare is a bomb waiting to detonate your coverage” by Emmanuelle B. Faubert, National Post, March 3, 2024  

An expensive plan that will make Canadian patients wait longer for fewer drugs” by Kathy Megyery and Pascal Chan, Financial Post, February 26, 2024  

The downsides to the NDP’s universal drug insurance plan” by Emmanuelle Faubert, Troy Media, November 7, 2023  

Pharmacare: More government could mean fewer drugs” by Emmanuelle Faubert, Hamilton Spectator, November 5, 2023  

Private-public collaboration is key to unlocking healthcare for all” by Zahid Salman, The Hill Times, August 3, 2023  

Benefits provider GreenShield to offer drug plans for people with no coverage” by Clare O’Hara, Globe & Mail, July 13, 2023  

New pilot project will provide free essential medications to Canadians with no drug insurance” by Dhriti Gupta, Toronto Star, July 13, 2023  


A failure to disclose


Canada’s media institutions widely recognize the importance of disclosing any conflicts of interest that sources may have, especially when it concerns reporting on health issues involving the pharmaceutical industry.  

The Canadian Association of Journalists (CAJ), for instance, has previously singled out health issues as an area rife with actors trying to push self-interested and potentially unreliable information into the public sphere. 

Its 2011 Ethics Guidelines states, “We use care when reporting on medical studies, polls and surveys, and we are especially suspect of studies commissioned by those with a vested interest, such as drug companies, special interest groups or politically sponsored think tanks.”  

In the “Health and Science” section of its Journalistic Standards and Practices, the CBC likewise states that journalists and editors should identify the sponsors of studies the public broadcaster reports on and inform audiences of potential conflicts of interest when “the study’s results favour the sponsor’s interests.” 

And yet, despite a clear awareness of the problem, establishment media outlets rarely, if ever, disclose the glaring conflicts of interest of pharma-funded think tanks and their experts when citing their research or publishing their op-eds on pharmacare. 



Resources

Myth-busting articles and previous research on Big Pharma’s echo chamber 

With the introduction of the Pharmacare Act (Bill C-64), Big Pharma and its echo chamber of think tanks and experts have turned up the volume on their efforts to sow doubt and confusion around the need for public, single-payer pharmacare.  

But hardly any of these bad faith arguments and falsehoods are new. They are accurately described by Dr. Joel Lexchin as “zombie arguments” against pharmacare – arguments that have been debunked and struck down time and again in previous rounds of debate: Worse coverage! Less innovation! Fewer new drugs! Growing federal deficits! 

Below is a list of articles written over the last few years by genuinely independent experts in the field of pharmaceutical and health care policy dismantling some of the most commonly-repeated lies and half-truths spread by Big Pharma, insurance companies, and their think tank allies. 

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Pharmacare: misconceptions and facts” by Dr. Douglas Eyolfson, Winnipeg Free Press, March 14, 2024  

With a pharmacare bill on the horizon, Big Pharma’s attack on single-payer drug coverage for Canadians needs a fact check” by Joel Lexchin, The Conversation, September 11, 2023 

97 per cent of Canadians have drug coverage and other lies drug manufacturers are pushing” by Steve Morgan and Nav Persaud, Toronto Star, July 31, 2023 

How the pharmaceutical industry uses disinformation to undermine drug price reform” by Joel Lexchin, The Conversation, January 9, 2023 

Understanding the Battle for Universal Pharmacare in Canada” by Marc-Andre Gagnon, International Journal of Health Policy and Management, March 2021 

It’s time to finally kill the zombies” by Dr. Joel Lexchin, International Journal of Health Policy and Management, December 2020 

Debunking the myths about a Canadian pharmacare program” by Katherine Boothe, The Conversation, July 23, 2018 

There is scarce in-depth research into how Big Pharma and its insurance company allies have bankrolled the work of think tanks and experts in Canada in an effort to fend off pharmacare and drug price regulation. One important exception is the 2019 study The Big Money Club: Revealing the Players and Their Campaign to Stop Pharmacare, authored by Sharon Batt for the Canadian Federation of Nurses Unions. This exposé seeks to extend some of the conclusions of that report. 

The Big Money Club: Revealing the Players and Their Campaign to Stop Pharmacare” by Sharon Batt, Canadian Federation of Nurses Unions (CFNU), March 2019 

In the U.S., however, numerous studies have teased out the tangled threads of funding and influence that connect think tanks to Big Pharma, aided in part by more stringent disclosure requirements for charitable donations made through corporate foundations. Below are several reports that cover much the same ground as this exposé, in the U.S. context. 

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Mapping the PhRMA Grant Universe: An analysis of the $6 billion in grants distributed by PhRMA and its member companies” by Mike Tanglis, Public Citizen, December 14, 2023 

The Cost of Capture: How the Pharmaceutical Industry Has Corrupted Policymakers and Harmed Patients” by Julie Margetta Morgan and Devin Duffy, Roosevelt Institute, May 22, 2019 

Inside Purdue Pharma’s Media Playbook: How It Planted the Opioid ‘Anti-Story’” by David Armstrong, ProPublica, November 19, 2019 

Smoke and Thalidomide” by Edward Nik-Khah, Perspectives, Whitlam Institute, May 2016 


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