a prescription for profit
Exposing Big Pharma’s campaign of misinformation on pharmacare
Table of contents
Institutions
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.
74
Number of recent op-eds & news articles on pharmacare featuring industry-backed think tanks
zerø
Number of conflict-of-interest disclosures
PHARMA TIES:
Innovative Medicines Canada, Pfizer, Eli Lilly, AstraZeneca, Undisclosed
The Fraser Institute, which touts itself as “Canada’s most influential think tank,” has long received funding from the pharmaceutical industry, and many of its leaders and experts on pharmaceutical policy are past or current employees of the industry or its lobby groups. Members of the pharmaceutical industry have sat on the organization’s board of trustees, and one lifetime patron (and former board member) was a senior director at Pfizer.
Despite their financial ties and vested stakes in the policies under discussion, experts from the Fraser Institute are regular contributors in the opinion pages of Canadian media, with no disclosure of any conflicts of interest. On pharmacare, these commentators have all echoed the same talking points favoured by the pharmaceutical and insurance industries.
Fraser Institute EXPERT SPOTLIGHT
PHARMA TIES: Pharmaceutical Researchers and Manufacturers of America (PhRMA), International Federation of Pharmaceutical Manufacturers and Associations (IFPMA)
Kristina Acri is a Senior Fellow at the Fraser Institute. A pharmaceutical industry consultant and university professor, she has authored several reports published by the Fraser Institute attacking pharmacare.
More about Acri
Since 2002, Acri has been employed as a consultant for the Pharmaceutical Research and Manufacturers of America (PhRMA), the all-powerful U.S. industry lobby group. Acri has also worked with the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA).
Acri is also a consultant with Partnership for Safe Medicines, a U.S.-based non-profit with deep ties to PhRMA. While the Partnership bills itself as a “grassroots initiative,” its executive director from 2007 to 2017 was a PhRMA vice-president and many of its member organizations are funded by the U.S. industry lobby group. As part of a wide-reaching campaign against foreign drug imports orchestrated by the Partnership, Acri has testified in more than a dozen U.S. states against the re-importation of medicines from Canada – what the industry calls “pharmaceutical counterfeiting.”
From 2003 to 2016, Acri worked for Ward Health Strategies (also known as World Health Advocacy), a health policy-focused government relations firm headed by former Ontario Liberal minister Christopher Ward. After his political career, Ward was a vice-president of both PhRMA and its Canadian counterpart, Rx&D (now known as Innovative Medicines Canada). Ward Health has worked closely with pharma-funded patient groups in Canada whose policy positions frequently mirror those of the industry.
None of Acri’s links to the pharmaceutical industry are mentioned in her biography on the Fraser Institute’s website.
Over the last two years, experts from the Fraser Institute have published 15 opinion columns attacking pharmacare. The op-eds appeared in news websites frequented by government insiders and policymakers, such as the Hill Times and National Newswatch, and sought out local audiences in outlets like The Winnipeg Free Press, The Toronto Sun, and The Niagara Independent.
None disclosed any conflicts of interest in the authors’ bios.
In addition, findings or experts from the Fraser Institute were cited four times – without any disclosure of financial ties to industry – including by CBC News and The Toronto Sun.
More about the Fraser Institute
The full scope of pharmaceutical industry funding flowing to the Fraser Institute is difficult to know. The think tank does not reveal the identity of its corporate donors because, it claims, “supporters of Institutes like ours have, in the past, been systematically harassed by activists who disagree with our work.”
What we do know is that since 2018, the Fraser Institute has received $1.5 million from drug maker Eli Lilly’s charitable foundation, the Lilly Endowment. Eli Lilly is a major producer of insulin and other drugs used to treat diabetes, and it has long supported conservative economists hostile to drug price regulation. The Fraser Institute has received a further $625,000 since 2018 from the hard-right Searle Freedom Trust, founded by the late pharmaceutical executive Daniel C. Searle.
In 2019, the Fraser Institute absorbed the Atlantic Institute for Market Studies (AIMS), a kindred think tank based in Halifax, Nova Scotia. AIMS had long been funded by pharmaceutical companies. Before the merger, it received donations from AstraZeneca and the Big Pharma lobby Innovative Medicines Canada (then known as Rx&D), according to its last financial disclosures.
When publishing research on pharmaceutical policy in the past, the Fraser Institute would routinely acknowledge “with gratitude those who financially support The Fraser Institute and this research, including research-based pharmaceutical companies.” The organization no longer includes conflict-of-interest declarations in its reports, though its funding relationships with the pharmaceutical industry have continued.
Reports and opinion columns on pharmacare from Fraser Institute experts all echo the same alarmist industry talking points. Two weeks after Bill C-64 was introduced in the House, Senior Fellow Kristina Acri warned in The Hill Times that the proposed new law would reduce drug coverage for millions of Canadians – a scare tactic favoured by the pharmaceutical and insurance industries. A national pharmacare program, she falsely claimed, would prohibit the purchasing of supplemental insurance for drugs not covered by the public plan.
Experts from the Fraser Institute have also faithfully echoed the industry-promoted myth that most Canadians already have access to some form of drug coverage through either the public or private system, championing industry’s preferred “fill the gaps” approach instead.
Jake Fuss, Director of Fiscal Studies, and Bacchus Barua, Director of Health Policy Studies at the Fraser Institute declared in The Hill Times that a national pharmacare program “won’t help Canadians who need it the most.” Rather than introducing a universal program as a “blunt instrument,” the Trudeau government should target only the Canadians currently struggling to pay for their medications, they advised.
Elsewhere, Fraser Institute experts have raised the specter of the financial burden of implementing a national pharmacare program. The Trudeau government is “not being honest” about the true costs to Canadians, wrote Jake Fuss along with Senior Policy Analyst Mackenzie Moir. The government will likely need to increase its debt, resulting in higher taxes, they warned.
Catherine Swift, who is on the Fraser Institute’s board of directors, called pharmacare a massively costly government monopoly, while economists Tegan Hill and Milagros Palacios warned that provinces would soon “find themselves on the hook for Ottawa’s big spending plans.”
These industry-backed experts have also threatened that a pharmacare program would reduce access to drugs. Nigel Rawson, a Senior Fellow at the Fraser Institute who is also affiliated with the Macdonald-Laurier Institute (see below) and does consulting work on behalf of pharmaceutical industry clients, wrote with Bacchus Barua that lower drug prices would be a disincentive for innovation, forcing pharmaceutical companies to bypass Canada in launching innovative medicines.
PHARMA TIES:
Innovative Medicines Canada, Pfizer, Roche, Novartis, GSK, Gilead, AstraZeneca, Johnson & Johnson
INSURANCE TIES:
Sun Life
The Canadian Chamber of Commerce represents more than 400 local chambers, boards of trade, and member corporations at the federal level.
While the Chamber touts its policy councils as representing “a diverse cross-section of organizations from across Canada,” the membership of its Life Sciences Strategy Council is dominated by pharmaceutical companies and lobby groups, including Innovative Medicines Canada, Pfizer, Roche, Novartis, GSK, Gilead, and AstraZeneca.
In the last two years, Canadians news media, including The Globe and Mail and The Toronto Star, have cited the Chamber of Commerce three times. The Chamber’s experts have also published two opinion columns in The Financial Post and iPolitics.
None disclose any conflicts of interest.
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:
Innovative Medicines Canada, Pharmaceutical Researchers and Manufacturers of America, Pfizer, Merck, Roche, Johnson & Johnson, AstraZeneca
The Macdonald-Laurier Institute (MLI), launched by conservative commentator Brian Lee Crowley in 2010, has quickly risen to prominence since its founding. The Institute is a leading right-wing think tank with close connections to the Conservative Party, and it has long enjoyed funding from the pharmaceutical industry.
Through donations and event sponsorships, the Institute has been funded by Pfizer, Merck, Roche, Johnson & Johnson, AstraZeneca, as well as both of the two major Canadian and American drug manufacturers’ associations – Innovative Medicines Canada and PhRMA – and a leading pharma-linked lobbying firm (3Sixty Public Affairs).
Experts from the Macdonald Laurier Institute appear regularly in the opinion pages of The Globe and Mail, The Financial Post, and The Hill Times to sound the alarm about the dangers of a national pharmacare program.
MLI EXPERT SPOTLIGHT:
Nigel Rawson & John Adams
PHARMA TIES: Johnson & Johnson, AbbVie, Bayer, Merck, GSK, Purdue Pharma
Nigel Rawson (Senior Fellow, Macdonald-Laurier Institute) is a pharmaceutical policy researcher who does research and consulting work on behalf of pharmaceutical industry clients.
More about MLI Experts
According to recent disclosures, his clients include Johnson & Johnson, AbbVie, Bayer, and Merck, as well as a host of other pharma industry associations and pharma-linked lobbying firms (the Canadian Forum for Rare Disease Innovators (RAREi), BIOTECanada, 3Sixty Public Affairs, Ward Health, and Medicines New Zealand).
From 2004 to 2012, Rawson was employed by the U.K.-based pharmaceutical manufacturer GlaxoSmithKline (GSK) – with one biography online touting him as “GlaxoSmithKline’s only epidemiologist in Canada.” From 2001 to 2004, he was a senior researcher at the Center for Health Care Policy and Evaluation, a research centre run by UnitedHealth Group, one of the United States’ largest private health insurers.
In 2016, Rawson authored a book on drug safety that was “highly recommend(ed)” by Purdue Pharma’s former CEO and President, John H. Stewart. The Sackler family-owned Purdue Pharma is notorious for its disregard of drug safety in aggressively marketing OxyContin, which helped to spark the opioid addiction crisis in North America. In the introduction to his book, Rawson describes Stewart as a “long-time friend” who read early drafts of the book manuscript and provided “valuable comments that have improved its content significantly.”
In addition to his role at the Macdonald-Laurier Institute, Rawson is an affiliate scholar with the Canadian Health Policy Institute and a Senior Fellow at the Fraser Institute.
PHARMA TIES: IMC, PhRMA, Novartis
John Adams (Senior Fellow, Macdonald-Laurier Institute) is the Board Chair of the Best Medicines Coalition, an alliance of pharmaceutical industry-funded patient groups. He is also the co-founder, President, and CEO of CanPKU and Allied Disorders Inc., which is sponsored by Innovative Medicines Canada and PhRMA and a member of the Best Medicines Coalition. Adams has received consulting fees from Novartis and Biogen Canada, according to recent disclosures.
From 2005 to 2016, Adams served in various leadership positions (treasurer, board chair) with the Canadian Organization for Rare Disorders, another alliance of pharma-funded patient groups.
Over the last two years, they have published 18 opinion columns attacking pharmacare – none including any disclosure about their financial ties to the pharmaceutical industry.
Since 2020, the MLI no longer lists specific corporate donors in its annual reports, though it’s worth noting that previous donor lists were incomplete to begin with, as some donors requested anonymity, according to the institute.
The MLI’s board of directors includes pharma lobbyist Wayne Critchley, a Senior Associate at Global Public Affairs, which is a leading lobbying firm that represents Innovative Medicines Canada, Johnson & Johnson, Bayer, and other pharmaceutical companies, according to the federal lobbying registry.
More About Macdonald-Laurier Institute
Critchley, a former executive director of the PMPRB (Patented Medicines Price Review Board), specializes in lobbying on issues that impact the pharmaceutical sector. He was also the Chair of the pharma-funded patient organization Canadian Organization for Rare Disorders from 2015 to 2019.
The MLI’s managing director Brian Lee Crowley is a veteran of the think tank world. In 1994, he helped found the Atlantic Institute for Market Studies. Prior to its incorporation into the Fraser Institute in 2019, AIMS was funded by many of the same pharmaceutical corporations as the Macdonald Laurier Institute, including Rx&D (the predecessor to the pharma industry lobby Innovative Medicines Canada), AstraZeneca, Bayer, Pfizer, and Merck, as well as insurance giants Great-West Life and Manulife.
Among the most prolific experts affiliated with the MLI are Senior Fellows Nigel Rawson and John Adams, who were brought on in April 2022 shortly after the Liberal government announced its intention to move forward with pharmacare.
Frequent co-authors, Rawson and Adams have slammed plans for a national pharmacare program, claiming that it would leave Canadians with rare diseases “worse off.”
They urge the government to spend less on pharmacare and dedicate funds to treatments for rare medical disorders instead, falsely presenting the two options as mutually exclusive.
In the Hill Times, Rawson and Adams make the absurd claim that “there’s nothing scarier” than government efforts to obtain drug prices comparable to other countries, which they deride as “rock bottom” prices. Policies that lower drug prices are tantamount to “guerrilla warfare” against Big Pharma, which Rawson and Adams blame for having reduced access to newer drugs in Canada. They dismiss the idea of starting pharmacare with universal coverage of commonly prescribed drugs as “minimal health care,” despite numerous studies showing the substantial benefits to patients and the health care system. “No one wants that.”
Elsewhere, Aaron Wudrick, director of the domestic policy program at the Macdonald-Laurier Institute, described the NDP’s efforts to secure a single-payer universal pharmacare system as ‘haranguing’ the government and warned that their “insistence on an ‘entirely public’ system should set off alarm bells for most Canadians.” A more effective and affordable option would be a targeted approach, he wrote, parroting industry talking points.
PHARMA TIES:
Innovative Medicines Canada, Pfizer, Johnson & Johnson, AbbVie, Roche, Sanofi, Merck
INSURANCE TIES:
Canadian Life and Health Insurance Association, Sun Life, Green Shield Canada, Canada Life
The Conference Board of Canada bills itself as “the foremost independent, applied research organization in the country,” and declares that its work is “evidence-based and unbiased.” The Board’s output is largely aimed at business leaders and policymakers rather than the broad public, and much of its funding comes from corporate Canada.
On pharmacare, the think tank’s research agenda has clearly been driven by the priorities of Big Pharma and the insurance industry.
In May 2022, the Conference Board released a report titled “Understanding the Gap 2.0,” which claimed that over 97% of Canadians are already eligible for drug insurance. Leading health policy experts have denounced this misleading statistic as one of the most pernicious “lies” told by drug manufacturers and other opponents of pharmacare.
More about The Conference Board of Canada
Pharmacare’s detractors routinely cite the Conference Board of Canada’s drug coverage report to make the case for a program limited to “filling the gaps.”
The report’s findings are also consistently brought up in news and opinion pieces in Canadian media.
But what these citations fail to mention is that the report was funded by Innovative Medicines Canada, the leading pharmaceutical lobby group. And the misleading statistic it contained was based on data from the Canadian Life and Health Insurance Association, the insurance lobby group.
According to the Conference Board of Canada’s pharma lobby-funded study, most Canadians “are technically eligible for private or public drug coverage.”
But as experts have pointed out, “the coverage in question involves high deductibles or costly premiums that households cannot afford.”
The 2022 report was an update of a similar study that the Conference Board had carried out in December 2017, which asserted that less than 0.5% of Canadians are unable to afford their medications due to the cost – a figure that has not been reproduced by any study before or since.
The 2017 report was funded by both Innovative Medicines Canada (IMC) and the Canadian Life and Health Insurance Association (CLHIA). Its introductory note explains that the research was overseen by an “expert advisory committee” composed of two IMC and two CLHIA representatives.
PHARMA TIES:
Innovative Medicines Canada, Johnson & Johnson, Pfizer, GSK, Merck, Novartis, AstraZeneca, Purdue Pharma
The Canadian Health Policy Institute (CHPI) is a think tank that produces research on Canada’s health system performance and health policy issues, with a focus on pharmaceutical policy. It publishes The Canadian Health Policy Journal, which is overseen by an editorial advisory board dominated by current and former pharmaceutical executives and industry consultants.
Brett Skinner, the founder and CEO of the CHPI and Editor-in-Chief of its journal, appears regularly as a commentator in Canadian media.
In the last two years, Skinner has written five op-eds, in The Financial Post, The Toronto Star, and The Hill Times, to argue against national pharmacare and the need to lower the costs of prescription drugs. None disclose any conflicts of interest in his bio. In addition, three news stories have cited Skinner’s views on pharmacare without mentioning his personal and institutional affiliations with the pharmaceutical industry, in The Canadian Press, Global News, and The Hill Times.
CHPI EXPERT SPOTLIGHT
PHARMA TIES: Innovative Medicines Canada
Brett Skinner is the Founder and CEO of the Canadian Health Policy Institute (CHPI) and Editor-in-Chief of its journal, Canadian Health Policy Journal. Just months after founding the CHPI in 2012, Skinner was hired by Innovative Medicines Canada (IMC) – Canada’s leading pharma lobby – as its Executive Director of Health and Economic Policy. Although Skinner left IMC in 2017, the CHPI remains closely connected by personnel and funding to the pharmaceutical industry.
More about Skinner
Prior to founding the CHPI, Skinner worked for eight years with the Fraser Institute, which also receives funding from pharmaceutical companies, as Director of Health Policy (2004-2012) and CEO (2010-2012). He previously worked for the Insurance Bureau of Canada’s National Health Issues Program as a Consultant and Policy Analyst.
As of September 2021, eight out of the 15 members of The Canadian Health Policy Journal editorial board were past or present employees of the pharmaceutical industry. Five members were previously high-level executives with Innovative Medicines Canada (IMC), the leading Big Pharma lobby group, including CEO and founder Brett Skinner.
Board member Sarah Lussier Hoskyn served as a director of research at IMC and co-authored many of the industry lobby group’s statements opposing public, single-payer pharmacare. In addition, seven members of the editorial board are affiliated with the Fraser Institute and allied think tanks (Atlantic Institute for Market Studies, Montreal Economic Institute), all of which are funded by the pharmaceutical industry.
More about Canadian Health Policy Institute
While the Canadian Health Policy Journal has all the trappings of a scholarly journal, pharmaceutical policy expert Marc-André Gagnon describes it bluntly as “a fake peer-reviewed journal in which one-sided analyses that would never be accepted in any peer-reviewed academic journal can easily be published.” The journal may lend a patina of academic legitimacy to its collaborators’ industry-friendly views, but the CHPI’s intent is anything but academic, according to Gagnon: “These one-sided studies can then … serve as the basis to secure op-eds in Canadian media.”
Funding for the CHPI is opaque, but the institute appears to operate on a “pay to play” model with pharmaceutical companies sponsoring research on topics of interest to them, including pharmacare.
The CHPI’s Canadian Access to Innovative Medicines (CA2IM) research program, which is chaired by its CEO Brett Skinner, is “sponsored in part by sales of corporate subscriptions to pharmaceutical companies.” The sponsors of this research are no longer listed online, but archived pages from the CHPI website show that it has been funded by Johnson & Johnson, Pfizer, GSK, Merck, Novartis, AstraZeneca, and Purdue.
From its inception in 2012, the CHPI has contended that “worries about drugs costs … are exaggerated” and it has sought to steer government thinking away from policies intended to lower drug prices, “including proposals for a national pharmaceutical program.” Many articles and reports produced by the CHPI are highly critical of public, single-payer pharmacare. Others take aim at the PMPRB, the body which administers Canada’s drug price controls – another frequent target of the drug industry’s ire.
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.
More about Montreal Economic Institute
Although the MEI does not reveal its sources of corporate funding, the Institute is known to be “generously funded” by the financial services firm Power Corporation, and the chairperson of its board of directors, Hélène Desmarais, is married to Power Corporation chairman Paul Desmarais Jr. Estimated at roughly $4.5 billion, much of the Desmarais family’s immense wealth is invested in the insurance industry through Power Corporation, which has a major stake in Canada Life, the largest life and health insurance firm in Canada.
The Quebec-based think tank indicates on its website that the financial and pharmaceutical sectors were its second- and third-largest corporate funders, respectively, together accounting for 39 per cent of its corporate funding.
Despite one of the Institute’s leading donors sitting on its board of directors, the MEI’s website insists there is a “Chinese wall” separating its researchers from the influence of its corporate donors. MEI policy positions are arrived at in “an entirely independent manner based on economic rationality and the available empirical evidence,” according to the website. Nevertheless, Michel-Kelly Gagnon, the Institute’s founding president, has lamented that “the question of our funding never seems to go away.”
That funding question, however, has done little to dissuade Canadian news media outlets – such as The Globe and Mail, The Canadian Press, The National Post, The Edmonton Journal and The Hamilton Spectator – from regularly citing research from the Montreal Economic Institute or publishing their analysts without disclosing the institute’s financial ties to industry.
A February 2024 report by the Montreal Economic Institute, which suggested that a publicly funded pharmacare program would slash Canadians’ prescription coverage, was cited in five stories in major news outlets in Canada without any acknowledgement of the think tank’s vested interests in the debate.
Emmanuelle Faubert, an economist with the MEI who authored that report, has written several articles slamming national pharmacare for jeopardizing coverage quality, causing delays for those who need innovative drugs, and only helping a small segment of the population. Meanwhile, Krystle Wittevrongel, a senior policy analyst with the MEI, lauded the Alberta government’s announcement that it would not opt in to a federal pharmacare program.
The MEI’s effort to frighten those with workplace drug plans is clear. In The National Post, Faubert describes Bill C-64 as “a bomb waiting to detonate your coverage,” based on the insurance industry-inspired falsehood that a pharmacare program will eventually “abolish” all private drug coverage.
In the Hamilton Spectator, Faubert reasoned that a universal pharmacare program was unnecessary, even for most of the uninsured. Faubert reached this conclusion by hypothesizing that the uninsured are mostly young, healthy people who would rather spend their money on things other than drug coverage. Since most people are choosing to be uninsured (and not, say, unable to find a job that offers health benefits), Faubert concludes that the best solution is a “targeted program” that is neither universal nor single-payer – in line with what the pharmaceutical and insurance lobbyists have been demanding.
PHARMA TIES:
Innovative Medicines Canada, Pfizer, Johnson & Johnson, Bayer, Merck, AstraZeneca
INSURANCE TIES:
Canadian Life and Health Insurance Association, Manulife, Canada Life, Sun Life
The C.D. Howe Institute is a right-wing think tank with close ties to corporate Canada. While it touts its research as “nonpartisan, evidence-based and subject to definitive expert review,” the policy councils that oversee its work are composed overwhelmingly of business executives, not academics.
Since March 2022, experts from the C.D. Howe Institute have contributed four op-eds about pharmacare and been cited three times in new stories in outlets such as The Toronto Star, The Financial Post, and The Hill Times. None disclosed any financial ties to industry.
While less overtly and ideologically opposed to a public pharmacare plan, the Institute’s experts have insisted that fiscal and jurisdictional challenges make such a plan unrealistic, advocating for a mixed-payer model instead.
C.D. Howe EXPERT SPOTLIGHT
Pharma ties: AbbVie, AstraZeneca, Roche, Gilead, Vertex (via 3Sixty Public Affairs)
Fred Horne (Senior Fellow) is a former Alberta Health Minister (2011-2014) and a Senior Advisor at 3Sixty Public Affairs. Led by seasoned lobbyist and former Pfizer Canada employee William Dempster, 3Sixty specializes in pharmaceutical policy and lobbies on behalf of numerous pharmaceutical companies, including AbbVie, AstraZeneca, Roche, Gilead, and Vertex, as well as several pharma industry lobby groups and pharma-funded patient groups, according to the federal lobbying registry.
More about Horne
Horne was also the co-chair of the Conference Board of Canada‘s Canadian Alliance for Sustainable Health Care (CASHC), a multi-million dollar research initiative that operated from 2011 to 2020 and was funded by Sun Life, Pfizer, Johnson & Johnson, Canada Life, AbbVie, Roche, and Innovative Medicines Canada.
Over two dozen member companies from the IMC and CLHIA – the leading Big Pharma and insurance lobby groups – paid to be members of the C.D. Howe Institute in 2022. On its Board of Directors, insurance company representatives hold three seats, including Bruce Gordon, a current director and former chairman of Manulife, as well as two representatives of the Desmarais family, who hold a controlling stake in Canada Life.
Big Pharma and the insurance industry are also well-represented on the Institute’s Health Policy Council, which reviews and guides the think tank’s research and policy memos about pharmacare. Of the 41 seats on the Council, one-third (14) are held by executives and lobbyists from pharmaceutical corporations and insurance giants. Innovative Medicines Canada sits on the Council, as do executives from Pfizer, Johnson & Johnson, Bayer, Merck, and AstraZeneca. Corporate executives and lobbyists from Sun Life, Manulife, and the Canadian Life and Health Insurance Association are also represented.
More about C.D. Howe Institute
The C.D. Howe Institute’s event “Pharmacare Back on The Radar: Canada’s Need for Federal-Provincial Cooperation” on October 26, 2023, was sponsored by Johnson & Johnson. It featured the Institute’s Senior Fellow Marcel Saulnier and Senior Policy Analyst Rosalie Wyonch, both of whom appear in Canadian news and opinion pieces as health policy experts without any mention of industry ties.
Saulnier is an associate with Santis Health, a government relations firm that represents pharmaceutical companies like Johnson & Johnson, Gilead, and Takeda and is currently lobbying the federal government on J&J’s behalf about pharmacare.
Chris Bonnett has also authored several op-eds on behalf of the C.D. Howe Institute. Prior to the introduction of pharmacare legislation, he urged the Liberals “to avoid the complexity of a whole new federal plan” and work to “improve our existing private-public model rather than replacing it.” In response to the introduction of bill C-64, he wrote that the legislation’s mention of a public, single-payer model was “particularly troubling,” which he falsely summed up as a “policy decision to replace existing private drug plans.”
This stance is perfectly in line with what the insurance industry wants, and that’s no accident: Bonnett is an insurance industry consultant and provides advice and research on prescription drug policy for insurers and employers. He has done research on pharmacare for Green Shield Canada, Telus Health, and PDCI Market Access, a firm that works closely with pharmaceutical companies.
Bonnett previously worked as a Director of Healthcare Business Development at Sun Life, followed by a brief stint at Manulife, two of the largest providers of private workplace drug plans in Canada. From 2003 to 2021, Bonnett served as an Advisory Board member for Sanofi Canada’s Healthcare Survey.
recommendations
Below are our recommendations based on the findings of this report.
For policymakers:
The government must require that nominees to the Committee of Experts mandated by the bill fully disclose all potential conflicts of interest.
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When selecting witnesses for review of Bill C-64, it is imperative that the deliberations of the Standing Committee on Health be informed by objective, independent experts in the domain of pharmaceutical policy and not unreliable science peddled by industry consultants posing as scholars or independent researchers. Pharmaceutical companies and the big insurers have had ample opportunity over the past few years to present their views on pharmacare to decision makers, and the committee should not waste its time hearing from think tanks that will only echo these self-serving viewpoints. Any effort to stack the list of witnesses with these industry consultants moonlighting as independent scholars should be rejected.
Once the legislation is passed, the government must require that nominees to the Committee of Experts mandated by the bill fully disclose all potential conflicts of interest. Any such conflicts must result in automatic disqualification from participating in the Committee.
For the public:
Write a short email to members of the Standing Committee on Health to share this exposé with them, and demand that industry-backed actors are banned from both the parliamentary hearing process and all future oversight of our pharmacare program.
Read more
As the Pharmacare Act, Bill C-64, moves through the parliamentary process, experts and advocates will comment on the bill and propose changes. It is imperative that the industry-backed voices we identify in this exposé are blocked from their usual access to decision makers, and that policymakers are aware of their industry ties.
Furthermore, the Pharmacare Act will establish a committee of five experts tasked with overseeing the implementation of universal, public pharmacare. Representatives from the pharmaceutical and insurance industry must be banned from this committee, so that our pharmacare program can be overseen democratically by truly independent experts.
Write a short email to members of the Standing Committee on Health to share this exposé with them, and demand that industry-backed actors are banned from both the parliamentary hearing process and all future oversight of our pharmacare program.
For journalists and editors:
Editors must inform their audiences of these financial and organizational ties.
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Readers deserve to know when the author of an opinion column or a cited expert in a news article have vested interests in the topic at hand. The failure to disclose such conflicts of interest undermines the essence of journalistic integrity, allows for the undue influence of corporate power over our public discourse, and can lead to a distortion of the truth.
When publishing the work of experts opposed to single-payer pharmacare who consult with pharmaceutical or insurance corporations, or who are affiliated to think tanks funded by these same corporate interests, editors must inform their audiences of these financial and organizational ties.
Editors ought to also reconsider publishing op-eds authored by experts whose impartiality and commitment to accuracy are compromised by their organizational or financial ties. These commentators have repeatedly put forth assertions that are lacking in evidence, and they have little credibility within the academic fields they claim to represent. The corporate giants opposing pharmacare have more than enough resources to pay to promote their perspectives directly – they don’t need our media to do their bidding for them.
Take Action!
Keep corporate-funded experts out of pharmacare committee!
Write to the Standing Committee on Health and other key decision makers to demand that they keep Big Pharma-funded “experts” out of the decision making and oversight of our public, universal pharmacare program!
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 disorders” by 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 usefulness” by 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 coverage” SaskToday.ca, March 10, 2024
“NP View: Provinces should reject Trudeau-Singh socialized pharmacare scheme” National 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 spotlight” The 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 drugs” Telegraph-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
