Sunshine is said to be the best of disinfectants.
— Justice Louis Brandeis


Trust is a vital sign in any health care system. And the therapeutic relationship is based on confidence that the decisions made by health professionals are made in the best interests of patients without any hidden conflicts of interest.

A high performing health care system also needs to ensure decisions are being based on the best available evidence. 

The current evidence suggests that industry involvement with such important tools as clinical guidelines is troubling. And when it comes to the effectiveness of certain treatments, we might be being misled as crucial data is being withheld

Involvement with industry may not taint judgements or opinions, but patients and the public should be informed when it comes to such interactions. The same is also true for health care providers whom rely on experts or institutions when it comes to making decisions. 

In Canada, the recent concern regarding national opioid guidelines underscores the uneven landscape of disclosure in our health system. Six of the thirteen members on the opioid expert advisory committee had ties to drug companies that manufacture narcotics. And while this should never disqualify opinion, the reporting of such conflicts were inconsistent with previous policies or procedures.

There is also still no public record of payments made to individual physicians and prescribers, let alone researchers who study whether new drugs and devices help or harm patients. Currently, only Health Canada and pharmaceutical companies have access to confidential data about patient clinical trials involving drugs and devices. And when looking upstream, the policies guiding drug industry engagement with Canadian medical schools are variable if not lax


The push for such transparency is not new. The United States--the world's largest and most sophisticated pharmaceutical market-- passed the Physician Payments Sunshine Act in 2013 to have all payments from as little as $10 reported to the federal government. Britain, France and Denmark have followed suit. 

And patients and the public want this information. Since 2010, Pro Publica has put together a user-friendly platform that now has over 13 million page views