Evidence of meeting #50 for Health in the 39th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was cdr.
A recording is available from Parliament.
Conservative
Chair, Canadian Expert Drug Advisory Committee, Canadian Agency for Drugs and Technologies in Health
Given that the focus today seems to be on the common drug review, I would ask this question. I think the provinces have already shown statistics saying that the proportion of drugs approved prior to CDR was similar to the proportion that are approved now with CDR. So the difference isn't because of CDR. There may be other factors to be considered. The evidence may be the same, but departments of health make decisions about whether they want to send more money towards waiting lists or pharmaceuticals. Those types of decisions may factor into this as well.
Assistant Deputy Minister, Pharmaceutical Services, British Columbia Ministry of Health
You're right that a difference of 62% in one province and 15% in another seems horrific. It would be of great concern to me. I don't know that study; I do not have a copy. But I can tell you that in the past when we saw big discrepancies, we found that the numbers weren't counted the same way. We'll find out why there is that difference.
What happened in the past in British Columbia is that people went to the Internet to look at what drugs were publicly available within the drug plans. Within British Columbia, none of the cancer, HIV/AIDS, or transplant drugs, or renal agents are included in the Internet listing for B.C. PharmaCare. That doesn't mean that we don't pay for them for the public; we pay for them through different agencies.
So perhaps the cancer drugs weren't counted, even though we provide them, but through the B.C. Cancer Agency, rather than through B.C. PharmaCare. This might not have been obvious to the people who were counting the drugs.
As I said, I don't know if that's the case in this example. But when we saw big differences like this before, we found this sort of discrepancy.
Conservative
The Chair Conservative Rob Merrifield
Thank you very much.
Now we have two more questioners. We have about six minutes left, so I'll allow three minutes each.
Mr. Fletcher, and then Ms. Kadis.
Conservative
Steven Fletcher Conservative Charleswood—St. James—Assiniboia, MB
Mr. Chair, listening to the testimony today, I have the impression that one way or another, all roads lead to Quebec. I look at the witness list, and we don't seem to have any witnesses from Quebec who can share the Quebec experience with us.
I'd like to suggest to the committee that we ask the chair and the clerk to get some witnesses from Quebec who can help us discern what is actually going on here.
Conservative
The Chair Conservative Rob Merrifield
Yes, that's not a question then. It's something that we will deal with. I believe we have a steering committee meeting, and we'll deal with it.
Conservative
Steven Fletcher Conservative Charleswood—St. James—Assiniboia, MB
No, it's not a question for the committee; it's more of a statement.
Conservative
The Chair Conservative Rob Merrifield
That's a fair comment, but we'll deal with it next Tuesday.
Ms. Kadis.
Liberal
Susan Kadis Liberal Thornhill, ON
Thank you, Chair.
I was interested in knowing, where is the CDR in terms of approved formulary coverage for biologics? Are we on a par with other countries, or are we behind?
Vice-President, Common Drug Review, Canadian Agency for Drugs and Technologies in Health
When we looked just at drugs, and defining biologics as those drugs that go through the bureau of biologics at Health Canada, setting aside the expensive drugs for rare diseases, seven out of seventeen biologics were approved through the CDR.
Another way of looking at this is to look at drugs that come to us where the manufacturers have indicated a request for a priority review on the basis that the drug offers a significant benefit to a life-threatening or very serious disease. We looked at those drugs as well. In the first three years, eleven such drugs were reviewed. Five of them had recommendations to be listed, and six did not. So again, the percentage for that basket of drugs did not differ very much from the other drugs.
Liberal
Susan Kadis Liberal Thornhill, ON
In terms of a comparative with other countries, where do we stand? Are we similar or are we less, in terms of approving those particular drugs?
Vice-President, Common Drug Review, Canadian Agency for Drugs and Technologies in Health
I'm sorry. I don't have information on approval of other countries and their guidelines.
Liberal
Susan Kadis Liberal Thornhill, ON
Mr. Chair, could we please get some information on that? The committee would benefit.
Conservative
The Chair Conservative Rob Merrifield
Certainly.
We have one more late-entry question from Ms. Brown, and I'll allow it.
Vice-President, Common Drug Review, Canadian Agency for Drugs and Technologies in Health
No.
Conservative
The Chair Conservative Rob Merrifield
That was easy.
Thank you very much for coming in. I appreciate the opportunity to be able to question you on CDR. We didn't expect you to say how terrible it was, and you defended the position well, although you did show some of the concerns you had and how to make it better. We take that into consideration.
I want to thank you for coming. I want to thank the committee for their good questions.
The meeting is adjourned.
