Shoppers takes page from Big Pharma, sponsors talks for doctors on medical cannabis, which it plans to sell

By | November 12, 2018

The pharmaceutical industry has done it for years, officially to educate doctors, unofficially to convince them to prescribe more of their medicines.

Now the practice of company-sponsored seminars by specialists known in the drug business as “key opinion leaders” — and criticized as salespeople in disguise – has come to the burgeoning world of medical cannabis.

Shoppers Drug Mart is running a series of events across the country to teach prescribers about the drug, as the 1,300-store chain prepares to become a major marijuana retailer.

The agenda plays up the “internationally renowned” speakers’ academic and health-care affiliations, but fails to mention that almost all have ties to marijuana-producing companies or private cannabis clinics.

The development underscores the growing corporatization of medicinal weed — and has critics of Big Pharma’s influence on doctors worried about a possible new front in direct-to-physician marketing.

“I think this is a serious problem,” said Dr. Joel Lexchin, a health-policy expert and emergency doctor in Toronto. “There is definitely a need for doctors to learn how to appropriately prescribe medical marijuana. But that should not be paid for by the people who stand to profit from increased sales.”

Sessions called “Medical cannabis: the future is now” have already taken place in Calgary and Vancouver, kicked off each time by a “welcoming reception,” and more are scheduled for Toronto and Ottawa this week.

Shoppers defended the events as a way to inject scientific knowhow into what’s become a wide-open marijuana market, saying the speakers have a wealth of knowledge, and do not tout specific cannabis brands.

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“Recreational cannabis is now more accessible and available than medical cannabis, increasing the risk that patients can and will self-medicate,” said Catherine Thomas, a spokeswoman for the pharmacy chain. “Ultimately, we believe the best way to support patients looking to use this therapy is through education for health care practitioners.”

Shoppers received a Health Canada cannabis-producing licence in September, expected to be the first step toward its pharmacies selling marijuana made by other companies.

The chain has been lobbying the federal government to let druggists dispense medical cannabis. Until that happens, its sales — once it receives a sales permit — would be by phone and online, with delivery to customers’ homes, said Thomas.

She did not respond to a question about how much the speakers are being paid but, in the pharmaceutical industry, key opinion leaders (also called KOLs) can earn $ 2,000 or more per talk.

Industry-funded presentations make up a large portion of the continuing medical education doctors receive, often because no one else will pay for the instruction. A number of studies, however, have found evidence they encourage less-than-optimal prescribing, while nudging physicians toward the sponsor’s products.

Events put on by the makers of Oxycontin, for instance, have been blamed for encouraging doctors to more freely prescribe narcotic painkillers, helping trigger North America’s opioid crisis.

Drug companies sometimes actually monitor prescription patterns before and after KOL talks, and dump doctors who fail to move the needle, former sales rep Kimberly Elliot told the British Medical Journal in 2008. “They are sales people,” she said.

There is definitely a need for doctors to learn how to appropriately prescribe medical marijuana. But that should not be paid for by the people who stand to profit from increased sales

The Shoppers seminars are billed as a way for health professionals to better understand the latest cannabis research, learn how to appropriately apply it to patients and “gain practical, hands-on tips.”

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What they likely won’t hear is any expert voicing skepticism about marijuana as a therapy.

None of the doctors contacted by the National Post were available for comment, but an online search reveals most do paid work for the industry.

They include a Vancouver internal-medicine specialist who is medical director of a private cannabis clinic and on the advisory board of four cannabis companies. There’s a Toronto palliative-care physician who had earlier been paid to give talks by three marijuana companies, and the director of pain research at a major Toronto hospital who is on the advisory boards for two cannabis corporations.

A Winnipeg oncologist appearing at a pair of sessions sits on the advisory board of another marijuana firm. And an American physician speaking to the Toronto event — at the Art Gallery of Ontario — heads his own cannabis consulting company, as well as being on the advisory board of two pot producers.

Virtually none of those affiliations is mentioned in the events’ program.

Critics acknowledge that cannabis has some medical promise, but say doctors need an unvarnished appraisal of the less-than-definitive evidence — not one from pot advocates with a financial stake in the business.

“I think it’s kind of unseemly,” Dr. Tom Perry, a clinical pharmacology expert at the University of British Columbia, said about the sessions.

“It does seem like the same type of marketing used for pharmaceutical products,” said Dr. Nav Persaud, a family medicine professor at the University of Toronto with a focus on prescription-drug use. “It is concerning.”

A new, more independent review of the topic, meanwhile, is about to come out. Perry said UBC’s Therapeutics Initiative, which assesses commonly used medicines, will shortly publish a paper on cannabis, concluding the evidence of its medical effectiveness is limited.

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