Health Committee on March 5th, 2013

[Dr. Pierre Meulien]

There are other things that are mapping towards attracting some of the translational stuff. You've mentioned some key ones that I believe are very powerful. As well you have this excellent interface between the researchers and the clinicians that we have in Canada.

We can do what is termed research-intensive clinical trials, and we should be able to do those better than anyone in the world. I think that with the single-payer system and the data we have on families—which, by the way, the rare disease group holds in fantastic regard, because we have the best percentage of hit rates, of being able to solve cases for rare disease in the world, because we have all the generational data. We have all the clinical phenotyping. We have all of the genomic data that goes along with that. It's very powerful stuff. It's very difficult for jurisdictions to get all of that right.

So I am more optimistic than he is.

[Dr. Aled Edwards]

But on this rare disease thing, I phoned six heads of R and D in pharma around the world. I said, “You have to come meet this group”. They all came. They're all going to invest because of exactly what you said. So yes, it will make a difference, but we shouldn't be complacent about it, right?

[Hedy Fry, Liberal, Vancouver Centre, BC]

No, no, no. I just think it's an advantage—

[Dr. Aled Edwards]

Absolutely.

[Hedy Fry, Liberal, Vancouver Centre, BC]

—that doesn't just look at our size as being “little Canada”. We have this particular advantage, the ability to do translational research.

You talked a little bit about this ability to mine all that information and then share it. There was a question, and again we're down to unintended consequences. There's such a thing as sharing.

[The Chair, Conservative, Joy Smith]

There are only 30 seconds to share this.

[Hedy Fry, Liberal, Vancouver Centre, BC]

How do you share for free and become such a good Boy Scout and at the same time get an advantage out of it? Could you give us a quick answer?

[Dr. Aled Edwards]

The operational thing about sharing is that there are databases you share, and the process of being involved in a collaboration gives you an intellectual edge. Anyone is free to take that intellectual edge and compete, and that's what they do, but the fundamental knowledge is shared so everyone competes on their brains. The pharma believe that by being involved they get to see more, learn more, and compete, but on a level playing field, and they're happy with a level playing field.

[The Chair, Conservative, Joy Smith]

Thank you for sharing.

Dr. Sellah.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

Thank you, Madam Chair.

My question is for Dr. Edwards.

You co-authored a paper entitled “New approaches to rewarding pharmaceutical innovation”. And in it, you list some of the drawbacks to drug patenting. They include high drug discovery costs, decreased sales revenues and skewed research priorities that favour incremental changes to existing successful drug therapies over the development of therapies for rare diseases. You argued instead in favour of public funding for basic research, clinical trials and royalty or reward-based schemes. Would medically innovative drugs cost people less if public funding were in place?

[Dr. Aled Edwards]

Absolutely, and we'll be able to quantify that and negotiate with pharma and say we will not pay that because it did not cost you that.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

That's a nice concise answer. Now for my next question.

What impact might your suggestions have on medical innovation?

[Dr. Aled Edwards]

If I understand the question, if we fund research more publicly, how is it going to affect innovation?

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

Yes.

[Dr. Aled Edwards]

I think if academia is funded publicly, we won't innovate as much as the industries involved do, and hence, I think we need to do it as a partnership where we have the push from academia and the pull from industry in the same partnership. It's not done anywhere in the world. Our project is doing it. I think it's the right balance and the way to discover new medicines faster, and it's perfectly in line with the government's and all parties' willingness to work with the private sector to make discoveries go more quickly into the clinic.

So it's sharing and it's also business sense.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

Thank you for your answers.

[The Chair, Conservative, Joy Smith]

Thank you very much.

Now we'll go to shared time with Dr. Carrie and Mr. Lizon, beginning with Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Madam Chair.

Dr. Edwards, we have a lot of experience here handling political studs, but you talked about these research studs. The way our system seems to be set up is that we have an inherent bias. We have a peer-reviewed system. It seems the same group of academics kind of move things around, and they're reviewing all these studies.

[Dr. Aled Edwards]

It's all over the world. It's not a Canadian problem, right?

[Colin Carrie, Conservative, Oshawa, ON]

I agree with you there. How do we get ourselves out of this situation? Is there something you could advise us around the table?

[Dr. Aled Edwards]

I honestly think exactly as your colleague to your right said: we need an assault on this. The genome is finite. There are only 20,000 genes. It makes perfect sense. Let's just do it. There's no incentive for professors, but industry can provide that monetary incentive. As the public, we say, “Fantastic—as long as we share”. We can do innovative research by getting the private sector involved, and they'll help push us into the unknown. That's the big difference. No one in the world knows how to do that because every time a pharma comes in, they think, "How are we going to share these imaginary riches that we're going to make?" Then there are lawyers and nothing happens. This model, driven by Canada, is a business-sense model that involves sharing, and it will go into the unknown.

[Colin Carrie, Conservative, Oshawa, ON]

Is there a way that we can incentivize those investments to stay in Canada? Basically any company can take that knowledge and may put the job somewhere else. And we've paid for it.

[Dr. Aled Edwards]

I think we can incentivize to ensure that the trials get done in Canada, but I'd be wary of messing around with the market system and saying that it has to be here because that won't work. We should be able to compete in our brains and our entrepreneurship. Having the customer come and collaborate with us is always a better way to do business because you understand the customer. That's why we have so many companies around the oil sands. If we can bring the customers to Canada, and they're not here now, we'll have a much more innovative system in drug discovery.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Thank you very much.

My question is on something I don't know enough about: genetics. Forgive my ignorance, but if you have someone's genetic code and you know some genes are defective or the code shows that person is going to get such and such a disease down the road, would it be possible to improve that code, change that code, or come up with a perfect code for that person? I know it's another utopian idea, probably, but are scientists working on this? If you discover that a person has defective genes, can a code be somehow changed, the genes be replaced? Is this one of the areas people are working on?

[Dr. Pierre Meulien]

This area is called gene therapy. It's being experimented with in Canada, at a clinical level, for a specific gene, for a one-at-a-time kind of thing. Changing everybody's code at a more multi-genetic level will be hugely challenging. We're not there, but for certain diseases of the eye, for example, there are clinical trials ongoing in Canada. Dogs have been cured of blindness through this gene therapy.