Nearly $50 million may sound like a lot of money for 10 pharmaceutical giants to have doled out largely to Canadian doctors in 2016.

But it is likely only a drop in the bucket of the secret payments drug companies made to physicians last year for services such as consulting, sitting on advisory boards, and delivering speeches.

How large the figure actually is remains unknown. That’s because only 10 of the more than 45 members of Innovative Medicines Canada, an industry association for brand-drug manufacturers, voluntarily released information this week about the payments. And of those 10, only four even bothered to release data for the entire year.

What the other 35 brand-name pharmaceutical companies — never mind 10 generic drug companies and 148 medical device manufacturers — paid to doctors and organizations last year remains hush-hush.

If the drug giants hoped this feeble offering would dampen demands from health care experts and the government for full transparency about the practice they were mistaken.

On Tuesday Health Minister Eric Hoskins rightly announced he would begin consultations this summer to see if pharmaceutical companies should be required to disclose all payments made to doctors.

They should. Full disclosure will make physicians more cautious about accepting payments that may influence how they treat their patients, and researchers can actually measure the effects of those fees on doctors’ prescribing habits.

The dangers for patients if the government doesn’t step in are great. Physicians who receive money from pharmaceutical giants, for example, may be more likely to prescribe drugs those companies manufacture.

And it isn’t out of the question that they might also feel compelled to influence their colleagues to do so, too, at local and international seminars they get paid to speak at — where pharmaceutical giants also pick up the tabs for everyone.

All of this can come at the expense of patient health if a prescription of diet and exercise or even another drug would have been more effective.

Nor would Ontario be going out on a limb if it demands drug companies be transparent about the payments.

Full disclosure is required in countries from Australia to Japan to the United States to many European nations. And the information released is instructive. A U.S. database, for example, revealed that individual doctors in that country receive hundreds of thousands of dollars from drug companies in gifts and consulting fees.

With this week’s pathetic disclosures, pharmaceutical companies have made it clear to the government they will not voluntarily report how much they pay individual doctors. Now the government must step in as quickly as possible and force the issue. Our confidence in Ontario’s health system depends on it.