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

9:15 a.m.

President and Chief Executive Officer, Canadian Agency for Drugs and Technologies in Health

Dr. Brian O'Rourke

Madam Chair, I can probably speak to part of that question. On having one single agency to provide that oversight from a purchasing perspective, that wouldn't be CADTH. We do not have the expertise in purchasing, and a lot of that purchasing aspect is done through the group purchasing organizations.

We think we might be able to play a role if and when we have future shortages. I have been a pharmacist for many years myself. We've faced shortages in drug supply ever since I've been a pharmacist, and we've dealt with them.

What we're dealing with now, however, are more frequent drug shortages. Making those preparations and having clinical information available to pharmacists, physicians, and patients is where we think we could play a role. We can be proactive in identifying, as Dr. Lexchin said, critical drugs for which there is perhaps only one supplier and for which some information needs to be available to clinicians. That's more the role we would play, versus having a role in the oversight of the procurement.

9:15 a.m.

Executive Director, Canadian Pharmacists Association

Dr. Jeff Poston

If I can add to that, I think it's a great question but a difficult one to find a solution for, because you have to look at some sort of partnership between the federal government and provincial governments to do so. Provincial governments make some effort to protect themselves, if you like, from the impact of shortages, with some generic drugs that have exception status on the formularies. When they’re single-sourced, they may be allowed to be sold at higher prices. The provincial governments have a role.

I think the federal government also has an important role. Health Canada has been developing some of that. We've seen it as a result of the Sandoz shortage.

Historically we've had this issue of the supply chain falling through the cracks. It's not something that is strictly the federal government's responsibility or the provincial government's responsibility. People have been happy to allow the manufacturers or pharmacies to manage the supply chain.

We certainly need a lot of discussion to work out the structure of some oversight agency. I think gathering data and gathering information is the first step.

One thing we have to think about is that we spend a lot of time regulating and approving new drugs that come onto the market. Then the organization that Mr. O'Rourke is responsible for, the common drug review, decides what's going to get listed. As a result, we spend a lot of time looking at what comes onto the market.

One thing we've got to look at is what goes off the market. One problem we've seen with a lot of drugs that have gone into shortage—and Sandoz is a specific issue of manufacturing, and that is another issue—is that they're old drugs. They've been generic for some time. They're low-value often low-volume drugs, but they're still clinically important. I think we have to look at how to address some of these older drugs that have been around for some time and how to keep them on the market.

9:15 a.m.

Conservative

The Chair Joy Smith

Thank you, Dr. Poston.

We'll now go to Dr. Leitch.

9:15 a.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

Thank you very much, everyone. I really appreciate your presentations.

My first question is for the Canadian Pharmacists Association. I apologize; I don't know if it's Dr. Poston or Mr. Poston.

9:15 a.m.

Executive Director, Canadian Pharmacists Association

Dr. Jeff Poston

I've got a Ph.D., so you can say Dr. Poston.

April 3rd, 2012 / 9:15 a.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

I didn't know, so I didn't want to be rude.

One item that's come up again and again is the working group, which had been focused on making sure that some recommendations were made to the minister. Your organization put forward that you were supportive of the voluntary system. In fact, I have the letter here that you were a signatory to. It’s greatly appreciated. You also commented on the websites and other things available that others could feed into, the fact that there was a central focal point already.

However, later, for whatever reason, you decided to go against your words as stated here and you stated something different; you said you wanted a mandatory system.

Why is there the difference in the media? What was the cause for concern, and what are your concerns with regard to the change?

9:20 a.m.

Executive Director, Canadian Pharmacists Association

Dr. Jeff Poston

I don't think we've ever actually advocated for a mandatory system, but Jeff has been chairman of that working group, so I'm going to let him respond.

9:20 a.m.

Jeff Morrison Director, Government Relations and Public Affairs, Canadian Pharmacists Association

Thank you very much for the question, and yes, we're aware of that letter. In fact, I wrote that letter.

We've been supportive of the voluntary system really from the get-go. In fact, we put together that working group. We brought together the organizations that are signatories to the letter, so we've been advocating—

9:20 a.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

Why the criticism in the media, then?

9:20 a.m.

Director, Government Relations and Public Affairs, Canadian Pharmacists Association

Jeff Morrison

What we've been talking about in the media, in particular—and I think we're referring to the role of Health Canada—are the items Dr. Poston spoke about in his presentation, which is what role Health Canada and the federal government can play in responding to shortages, not with respect to the reporting system.

As I say, we've been leading this working group that has been working towards a very robust voluntary system. We're still not there, but what we do think, and what Dr. Poston articulated, is that Health Canada needs to take on the proactive role that it took with respect to Sandoz. As Dr. Poston mentioned, that's a role we think Health Canada should have been playing before Sandoz and, more importantly, a role they should be playing moving forward.

9:20 a.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

Then why is your attitude different in public than it is here in this room? I think we all are in this together. We want to take care of patients. I'm sure pharmacists do just as much as clinicians do, but why the difference in your presentation to the media and your aggressive attitude on that when we're all trying to be in this together?

9:20 a.m.

Executive Director, Canadian Pharmacists Association

Dr. Jeff Poston

I don't think.... I think there's perhaps been one media interview in which, as Jeff Morrison has explained, we talked about the importance of Health Canada's role. I think if you look at our press release and media statements in general, we've been pretty consistent in supporting a voluntary reporting system, but also, I think, pointing out that it if you look at the potential agencies and organizations out there that can play a role in affecting the situation, then clearly Health Canada has an important leadership role.

Believe me, drug shortages are not created by any one group or any one agency, and they're definitely not going to be solved by any one group or agency. I think it is very much a case that we are all in this together.

9:20 a.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

To go back to Mrs. Davies' question, Dr. Lexchin, you did comment in your note about Connaught Labs. I think the impression with Mrs. Davies is that it was a federal government entity. Do you want to give a little elaboration on that? I know what Connaught Labs is. I think you know what Connaught Labs is. Just so people are clear on where that entity came from....

9:20 a.m.

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

Dr. Joel Lexchin

Okay. Connaught Labs—my history may be a little rusty—grew out of the University of Toronto after they discovered insulin, but it was taken over in the late 1970s, I think, by something called the Canada Development Corporation. It wasn't a federal department, but it was federally owned. I believe it operated something like Air Canada used to or CN used to when they were publicly owned.

At that point, in the early to mid-1980s, it was making insulin and vaccines. It subsequently was sold off to Sanofi Pasteur, so it no longer is a public company. In fact, it's been merged a few times.

9:20 a.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

To be clear, Connaught Laboratories was actually generated because of Banting and Best. It was so that insulin could be commercialized. Its site is in northern Toronto so that it could prove that purpose. It was never a federal government entity, nor was it actually a provincial government entity; it was an entity of the University of Toronto.