Roughly half of Canada’s research-based pharmaceutical companies are voluntary members of Rx&D, a national association that promotes an industry code of ethics. The code outlines strict procedures for promotion and advertising to which members must adhere, and even prohibits health professionals from playing in drug-company-sponsored golf games. Penalties are up to $50,000 for every infraction after a third violation of the code.

Rx&D spokesperson François Lessard sidesteps the issue of direct-to-consumer advertising, saying it isn’t an immediate priority. He emphasizes that Rx&D helps preserve the independence of physicians when deciding what to prescribe and when. A $50,000 penalty amounts to a slap on the wrist for a pharmaceutical company, and the worst penalty for continuing breaches of Rx&D’s code of ethics is merely expulsion from Rx&D, a voluntary organization in the first place. To avoid the penalties, a company simply doesn’t have to be a member.