Health Committee on June 12th, 2014

[Eve Adams, Conservative, Mississauga—Brampton South, ON]

Thank you.

You have been outstanding in coming forward with information for consumers.

When patients pick up their medicine from you, you said very plainly that you're the ones who are advising patients what they can and can't take, how they should take it, what it might interact with. But when we do have the most adverse drug reactions, typically those people are being rushed into emergency rooms. That's why, obviously, we're having the reporting focus on our hospitals and asking our doctors to fill out those reports.

This is a collaboration, and we need to ensure that we work with all industry stakeholders and the entire health profession to ensure that Canadians are receiving the best possible information to make the most informed choices. We are never going to be able to eliminate all risk. It's a matter of making sure that people are informed and that we mitigate all possible risk.

Thank you very much.

[The Chair, Conservative, Ben Lobb]

You still have two and a half minutes.

[Eve Adams, Conservative, Mississauga—Brampton South, ON]

Oh, we have plenty of time.

[Jeff Morrison]

Mr. Chair, one of the things that pharmacists have been trying to do over the past several years is to advocate with their provincial governments to increase the scope of practice, increase the service they can provide to patients. In pretty much every jurisdiction in this country, pharmacists now can do more than they could even five years ago. The primary reason we've advocated for that, and I might add we've done so quite successfully, is to broaden the ability of the pharmacist to interact with the patient to ensure better drug safety.

For example, one of the new services that pharmacists can now provide that they couldn't a couple of years ago is a comprehensive medication management review, whereby a pharmacist can sit down with a patient, review the medication history of that patient, review what they are and are not taking, and come up with a care plan. That service has only been in place for several years.

Again, it's not just something that pharmacists are talking about from a legislative standpoint, but in their day-to-day interactions with patients. Safety is paramount. It is priority number one, and we are trying to provide ourselves and pharmacists with the tools to ensure better drug safety for that patient.

[Eve Adams, Conservative, Mississauga—Brampton South, ON]

As you may know, this committee is studying the scope of practice and is particularly supportive of increased scope of practice for pharmacists, in particular, the ability to provide immunizations. I'm of European descent, and in Europe for quite some time now you've had the traditional apothecary where you could have your medication provided by the pharmacist at hours that are convenient to you or to young families and so on. It's certainly much more efficient for the entire health care system.

We of course suspended that study to bring forward this critical piece of legislation. I think you would concur that this legislation is imperative to deal with so that we may proceed. It's been waiting now for decades. Obviously there are lives to be saved potentially by enacting this legislation. I think we can certainly all agree around this table that this was critical to bring forward.

[The Chair, Conservative, Ben Lobb]

Thank you very much.

The bells are ringing and there is a vote, as I'm sure you all know, at a quarter to 11. As always, I'm at the will of the committee. Mr. Scarpaleggia would be next. Does anybody have any thoughts if we want to do Mr. Scarpaleggia's round or suspend now? I'm open to suggestions.

Ms. Davies.

[Libby Davies, NDP, Vancouver East, BC]

With all due respect to Mr. Scarpaleggia, I'd love you to have your question, but because of the time needed to get back I feel we should suspend now.

[The Chair, Conservative, Ben Lobb]

Okay, is everybody in agreement with that?

By the time we get back it'll likely be about a quarter to 11, so at that point does the committee have any interest in asking more questions of the witnesses or do you want to get to the clause by clause?

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

What time are we coming back? Will I have my question when we get back?

[The Chair, Conservative, Ben Lobb]

We'll probably get back at a quarter to, but I'm not sure.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

You mean back to the committee room at a quarter to?

[The Chair, Conservative, Ben Lobb]

We'll be back at around quarter to 11, maybe 11 o'clock.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

So I'll get my question in.

[The Chair, Conservative, Ben Lobb]

What does the committee want to do?

[Eve Adams, Conservative, Mississauga—Brampton South, ON]

May I suggest the following? Just so that we don't have these witnesses stay here for such a long period of time, I would prefer that we suspend. You know, we do have a walk to make.

But would you perhaps like a one- or two-minute round?

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Sure.

Is that okay, Chair?

[The Chair, Conservative, Ben Lobb]

Go ahead.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Ms. Wilhelm, you mentioned something that I didn't fully understand or didn't quite catch. You said that if this bill had been in place, those who needed Vioxx would have had access to it.

Did I misunderstand what you said?

[Linda Wilhelm]

Vioxx as a drug was intended for people like me, those who take non-steroidal anti-inflammatory drugs. We see those over the counter with ibuprofen and naproxen drugs. They have the same risks as Vioxx had, but because Vioxx was withdrawn, people like me now have fewer options. If you can't take the one remaining drug, which is Celebrex, you can get a stomach bleed, which is far riskier for my health population than the high blood pressure and cardiovascular risks of Vioxx.

What was happening was that it was being prescribed for everything from tennis elbow to PMS. It should have been reserved for people like me. We take drugs like Methotrexate, which is a cancer drug. We take biologics. We take all these serious drugs.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

How would this bill being in place have allowed it to be on the market for your condition?

[Linda Wilhelm]

Health Canada would have had the power to call for more studies, and we could have had the label changed to say that this drug is only prescribed for people with inflammatory—

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

I understand. Thank you so much.

One more minute?

[The Chair, Conservative, Ben Lobb]

Sure. Go ahead.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

In terms of natural health products, there have been some questions about manufacturing sites overseas. This is not just an issue for natural health products but also for drug manufacturers everywhere. For example, there's some suggestion that some sites may not be up to standard, that some drugs have come in with things in the bottle that should not be in the bottle, and so on and so forth.

I don't know how this bill will fix that, necessarily, but is this also an issue with some natural health products? You say that you need.... The government looks at the manufacturing site, but how rigorous is the government in ensuring that manufacturing sites overseas are up to scratch, up to par, with the manufacturing sites here?

[Helen Long]

The natural health product regulations, the good manufacturing practices requiring a site licence, do apply to facilities used for Canadians overseas, and are still subject to the same requirements.