Evidence of meeting #38 for Health in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was drug.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

  • Brian O'Rourke  President and Chief Executive Officer, Canadian Agency for Drugs and Technologies in Health
  • Jeff Poston  Executive Director, Canadian Pharmacists Association
  • Joel Lexchin  Professor, School of Health Policy and Management, York University, As an Individual
  • Jeff Morrison  Director, Government Relations and Public Affairs, Canadian Pharmacists Association
  • Paul Glover  Assistant Deputy Minister, Health Products and Food Branch, Department of Health

9:20 a.m.

NDP

Libby Davies Vancouver East, BC

That's not what he just said.

9:20 a.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

I can tell you, because I sat in Banting and Best's office and I know the history of it. It was not a federal government entity at any point in time, nor was it a provincial government entity. It was an entity of the University of Toronto—

9:20 a.m.

Professor, School of Health Policy and Management, York University, As an Individual

9:20 a.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

—which is a publicly owned institution—

9:20 a.m.

Professor, School of Health Policy and Management, York University, As an Individual

Dr. Joel Lexchin

No; it was, in fact, owned by the Canada Development Corporation in the mid-1980s, but we can—

9:20 a.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

It went from there to private ownership.

We can beg to differ on that. I'm happy to have the discussion about it, but it was generated by the University of Toronto. It was not a federal government entity, so....

9:25 a.m.

Conservative

The Chair Joy Smith

You still have two minutes, Dr. Leitch.

9:25 a.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

Sure.

I wanted to ask you a little more, Dr. Lexchin, on one of the issues you brought up with regard to your recommendations.

My general impression is that you believe that it's the role—and I'm just asking for a specification on this—of the federal government to make the decisions with respect to pharmaceuticals and which hospitals receive them under what circumstances?

When I stand in the OR—and I mentioned this last week to those at the CMA—I don't pick up the phone and call the Minister of Health when I run out of a drug. I think you probably don't do that in the emergency department when you have a challenge. Could you outline your understanding of what happens when you have that shortage in your emergency department? Who do you go to in your institution to try to rectify that?

9:25 a.m.

Professor, School of Health Policy and Management, York University, As an Individual

Dr. Joel Lexchin

Actually, we were discussing this yesterday at the pharmacy and therapeutics committee meeting of the University Health Network.

They try to plan in advance for what they know about shortages coming down the pipeline. If they have anything less than a one-month supply of product, they consider that there may be a potential shortage, so they go looking for alternative suppliers. If they can't find alternative suppliers, then we come up with a plan of what we can substitute for drugs that may be in short supply, or we ask departments in the hospital that are heavy users of those products to consider limiting them or switching to alternatives.

9:25 a.m.

Conservative

The Chair Joy Smith

Thank you, Dr. Lexchin.

Now we'll go to Dr. Fry.

April 3rd, 2012 / 9:25 a.m.

Liberal

Hedy Fry Vancouver Centre, BC

Thank you very much, Madam Chair, and thank you all very much for coming today and expanding on this topic so that we can understand the many factors bearing on the situation we find ourselves in at the moment.

I was going to ask Dr. Lexchin about Connaught, but I think some of us are going to do some research on it and see. In fact, I think I remember that Connaught, if not government owned, was overseen by a public agency of the government at some time, in the same way, as you said, Air Canada was. I think there was a public component to it at some time.

This is something many people meeting with me have talked about. It's the concept, the idea, of looking at it. You cannot force a private company to make a drug. There's absolutely no way any government can do that. However, is there a way the government will have to belly up to the bar and look at finding a way to make sure that the absolutely necessary drugs for patient health and well-being are going to be accepted?

I just wanted to ask a couple of things. I'd like to go to Dr. Poston.

You've mentioned the U.S. Food and Drug Administration a couple of times. You mentioned that if we're looking at a global shortage, it might be worth our while—and I agree with you, actually—to start building blocks of people who can come and find solutions, either proactively or otherwise. The federal government and the U.S. Food and Drug Administration working together is a good idea.

Can you tell me, or can you flesh out for me, what exactly the U.S. Food and Drug Administration does to ensure that a shortage doesn't come and hit them between the eyes? How do they try to be proactive and prevent this from going on? I know that they take a very proactive role and I know that President Obama has actually pushed them to do even more. Can you just tell me what they do?

9:25 a.m.

Executive Director, Canadian Pharmacists Association

Dr. Jeff Poston

I'll start, and Jeff can perhaps add some stuff, because he met recently with the FDA.

There are a couple of things. For a number of years, the FDA had a position very similar to Health Canada's. They were not, historically, necessarily that proactive with respect to drug shortages. However, drug shortages have probably been a bigger issue in the United States than they've been in Canada, so there really was a need.

Like Health Canada, the FDA's responsibility was regulating drugs that came to market, but they took this additional role on in response to hospital pharmacists starting systems in the U.S. to address drug shortages and health care. They got the FDA involved in doing that. They have recently, as you said, as a consequence of a new executive order from the President, had more authority, and they have added some staff to do it.

Jeff, you might want to add to that.

9:25 a.m.

Director, Government Relations and Public Affairs, Canadian Pharmacists Association

Jeff Morrison

Yes. I had a great conversation with the acting director of compliance in the FDA, and I asked that exact question: “What do you do?” The FDA claims that in 2011 they alleviated roughly 190 to 195 shortages, so clearly they're doing something right.

What they said is that when they're alerted to a shortage—and they indicated that there's a high level of trust between manufacturers and the FDA—they essentially go through a four-step process.

Step one is to speak with domestic producers that have the capability to increase capacity for whatever drug is in short supply and to essentially request that they increase production.

Step two is to look at the drugs that are essentially in the approvals queue. They'll bring any drug that could be deemed an equivalent or an alternative to the drug in short supply to the top of the line; they'll expedite that particular drug.

Third, they'll talk to domestic producers that do not have the capacity to ramp up production and ask them if they could put that capacity in place.

Fourth, they'll look at foreign suppliers and issue the proper importation permits for foreign supply, again, of whatever drug.

They've indicated that as a result of this very proactive approach that they take, they've been able to alleviate roughly 190 shortages in 2011.

9:30 a.m.

Liberal

Hedy Fry Vancouver Centre, BC

Thank you very much, Mr. Morrison.

Madam Chair, with your permission, I want to say that we have just researched this, Dr. Lexchin, and this is what we found: Connaught had grown under the university, but by the late 1960s, it became obvious that it was inappropriate for a university to own what had become a commercial enterprise. Because the federal government was concerned that this unique commercial concern should remain in Canadian hands, the Canada Development Corporation purchased it in 1972.

Do I have any more time, Madam Chair?

9:30 a.m.

Conservative

The Chair Joy Smith

You do. You have about a minute and a half.