Thank you, Mr. Chairman, and thank you for the opportunity to present to the standing committee today.
The Canadian Pharmacists Association is the national voice of Canada's 29,000 pharmacists.
The focus of our submission today is patient safety and the need for federal investment to ensure a more effective post-market surveillance of pharmaceuticals. As we all know, pharmaceuticals are playing an increasingly important role in our health care system, but as more and more Canadians benefit from drug therapy, the number of drug safety concerns and adverse drug reactions is rising. Adverse drug reactions are sometimes discovered--in fact, it would appear these days that you could almost say they are usually discovered--after extended use of a pharmaceutical product in real world conditions. We saw another example in the media last week, where a painkiller that had been used for many years was linked to increased heart attacks. Over 10,000 adverse drug reactions were reported to Health Canada last year, but this is estimated to only be about one-tenth of the actual events.
Last year the federal government budgeted $170 million over five years to implement a series of measures to enhance the safety and effectiveness of drugs. While this is a much needed investment, our concern is that the bulk of this funding is targeted towards pre-market approval of drugs, getting new drugs to the market earlier, rather than post-market surveillance in order to assess the safety of drugs in real world use.
Our recommendations centre on the need for significant investment in infrastructure that will enable health care practitioners to contribute to a well-designed program to support effective post-marketing surveillance. The development of this model is essential to the implementation of the progressive licensing framework being proposed by Health Canada.
CPhA recognizes the need for a new progressive licensing framework for pharmaceutical products that will support access to promising new drug therapies while continuously monitoring and assessing for potential safety and effectiveness. Under progressive licensing, patients could receive newly marketed medicines earlier from pharmacies, and monitoring the reporting on these new drugs would be completed by qualified health care professionals.
However, we are concerned that the resources required to implement and maintain such a program are inadequate, making it ineffective.
CPhA would like to see an additional $150 million over 10 years committed to improving drug safety and effectiveness for all Canadians, including the development of a progressive licensing framework.
We further recommend that an additional $50 million over five years should be invested in developing electronic tools for pharmacists, physicians, and nurses, allowing them to better participate in the ongoing surveillance of drugs for unwanted effects. Such tools need to be integrated into pharmacy and clinical management software systems used by health care professionals.
The development by Canada Health Infoway of a new system for public health surveillance may have some potential to be further developed to meet the needs for post-market surveillance of drugs.
A recent study indicated that only 63% of physicians and 44% of nurses knew how to report an ADR as compared to 92% of pharmacists. Therefore, we recommend that an additional $10 million over five years should be invested in training health care professionals in the monitoring of drugs for adverse effects.
These recommendations we're putting forward today are also supported by our sister organization, the Canadian Association of Chain Drug Stores.
Appropriate developments in training and in technology are key to better evaluation and measurement of real world drug safety and effectiveness. While the federal government is appropriately emphasizing pre-market evaluation of drugs, post-market surveillance is increasingly important and also needs to be adequately funded. This will be a key to a successful progressive licensing program.
Thank you.