Health Committee on April 25th, 2007

[Dr. Braden Manns]

In 2004-05, we had 11 or 15, I believe.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Is that the number that have come before you?

[Dr. Braden Manns]

I think we had 14, actually, and about nine of those were based on data just around non-clinical end points. Some were approved. Two of the ones that came with just data on non-clinical end points were approved, and of the remaining five that had clinical end-point data, I'm not actually sure what the statistic is.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

If they're not approved, would these patients then have alternative pharmaceutical treatments available to them, or what do they do then?

[Dr. Braden Manns]

For instance, for some of these things, standard of care would include other potential medications as well or, in that particular situation, lowering phosphorus in the diet and that sort of thing.

I should say that in some of these examples, if they're not able to get regulatory approval, they will move on to do studies that look at clinical end points. They have started a big study that will give us that data over the next three to four years. Investing in these drugs before that may not be a wise investment if we don't know that it actually improves the health of Canadians, which is what we're trying to promote.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thank you.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

Ms. Kadis.

[Susan Kadis, Liberal, Thornhill, ON]

Thank you, Mr. Chair.

Welcome, and thank you for your presentations.

We are investing significant money in research and development, as you know. My concern is, are other patients in other countries getting increased access to our innovative therapies and discoveries, more so than Canadians?

We did hear some reference to that and some concern that was raised. I know you also referenced that in your remarks. In other words, we're making the discoveries, and others are having increased access to those innovative therapies, more so than Canadians. That was the concern that had been raised.

[Mike Tierney]

The study that Dr. Sanders referred to that was done on behalf of Rx&D Canada reported a range from a low of 16% of a basket of 50 drugs being recommended for approval to a high of 82%. The common drug review is at 50%. So we're pretty much in the mid-range of that access continuum, recognizing that there are limits with that. If we had different processes in place in terms of different levels of reimbursement, or if we had a process for national price negotiation, there's a chance that there would be more similarities if the processes were similar across countries.

[Susan Kadis, Liberal, Thornhill, ON]

Perhaps it would benefit the committee, Mr. Chair, to have this range laid out for us. We think it's a very substantial issue for Canadians. We would do the investments here in R and D, again very significant, and others in other countries may potentially benefit more so. If that is a fact, I think we need to know, and why if that is so. I think we would benefit from that information, if the committee could receive that.

[The Chair, Conservative, Rob Merrifield]

Yes, they could provide that.

[Susan Kadis, Liberal, Thornhill, ON]

Just to hear the range I don't think really pins it down enough. I guess probably all of us would want to feel we are facilitating innovative therapies as best we can, so Canadians can benefit in terms of increased access.

[The Chair, Conservative, Rob Merrifield]

So you're asking for information?

[Susan Kadis, Liberal, Thornhill, ON]

Yes, exactly.

[Robert Nakagawa]

Not necessarily speaking directly, but I think it's important for the committee to recognize that the common drug review process doesn't differentiate drugs based on their country of origin. In fact, that information is sometimes very difficult for us to know.

Recently, I found out that Vioxx was a drug that was discovered in Canada. But I would have been quite disheartened if it were treated differently from the rest of the drugs because it was discovered in Canada.

So we take a very objective view. Our feeling is that if drugs are discovered in Canada, they still need to meet the same standards of evidence to ensure that they are still safe and effective and are competitive and are worthwhile investments for taxpayers, not from an R and D perspective but from a health perspective.

[Susan Kadis, Liberal, Thornhill, ON]

You made reference to a national pharmaceuticals strategy task force or task group. Just to ask you a little more about that, when was that struck or appointed, and who's on that?

[Robert Nakagawa]

The national pharmaceuticals strategy was identified as part of the 2004 first ministers health accord, and the Premier of British Columbia committed to co-lead the provincial jurisdiction. Subsequent to that, the health ministers undertook to move forward with the national pharmaceuticals strategy. The task force is the group that's been delegated with the task of doing the work and making recommendations to the deputy ministers for moving that agenda forward.

I don't know if that's direct enough.

[Susan Kadis, Liberal, Thornhill, ON]

Can you tell us who serves on that?

[Robert Nakagawa]

Every province except Quebec is a participant as well as the federal government and the territories.

[Susan Kadis, Liberal, Thornhill, ON]

There was a drug that last week, I believe we heard, was turned down by CDR, but in B.C. I believe you had approved it. Are you familiar with that? That was raised, I think.

[Robert Nakagawa]

No, I'm not.

[Susan Kadis, Liberal, Thornhill, ON]

I'm not sure what it was for, but this is the type of disconnect we're trying to understand: why, and what rationale there is.

[Robert Nakagawa]

I don't know what example was being put forward. If that information were to become available, I'd be happy to respond.

[Susan Kadis, Liberal, Thornhill, ON]

Okay.

Thank you, Mr. Chair.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

I will now move on to Mr. Batters. You have five minutes.