Health Committee on May 9th, 2007

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

It's also interesting to note that the point of view that has been expressed often leads to the most expensive drugs, and they're also the most risky. I wonder if another member of the committee could explain what evidence there is to support the benefit-risk ratio in regard to some of these newer drugs versus the cost.

[The Chair, Conservative, Rob Merrifield]

Anybody?

[Linda Wilhelm]

Can I respond to that?

I was going to begin by giving my own personal history. I have rheumatoid arthritis. I was diagnosed in 1983 at the age of 23. My first prescribed treatment was 16 Aspirins a day, until there was nothing left of my stomach.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Mr. Chair--

[The Chair, Conservative, Rob Merrifield]

I'm sorry, Mr. Fletcher.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

My question was directed at the coalition, not the individual.

[The Chair, Conservative, Rob Merrifield]

Mr. Fletcher, no.

I'm sorry about that. Go ahead, Ms. Wilhelm. You can answer. The question was asked. How you answer is up to you. You go ahead and answer, but you're going to have to do it very quickly.

[Linda Wilhelm]

Yes, I will do it very quickly.

It just goes to why the expensive drugs are needed, which is what he referred to. I started with the cheapest drug that you could ever imagine, aspirin. I then went to another cheap drug called Plaquenil, then to another cheap drug called Cupramine, and then to another. And I didn't care about the cost of the drug. I wanted a drug that would work.

Twenty years later, 13 joint replacements later, a wheelchair, and a year in bed, I got access to a breakthrough called Enbrel, a biologic, at that time probably one of the most expensive drugs on the market at almost $20,000 a year. Within six weeks I walked out of the hospital after being in there for three months. I now walk three kilometres every single day. That's why we need expensive drugs.

[Some hon. members]

Hear, hear!

[The Chair, Conservative, Rob Merrifield]

Okay. Thank you very much.

Mr. Marston, you have five minutes.

[Wayne Marston, NDP, Hamilton East—Stoney Creek, ON]

Thank you, Mr. Chair.

Being new to this committee, I certainly find it very interesting. But something has percolated to the surface here and I can certainly understand that.

I want to thank Ms. Binder for her directness on the question in regard to funding. Some may have felt it should have been disclosed beforehand. I didn't see any reservation on your part in responding, and I appreciate that. And I can understand that a person who has difficulties in their life would feel an alignment to some extent with pharmaceutical companies who supply the benefits to them. I think that's perfectly reasonable.

I would be curious, though, if any of the presenters have any association or receive funding from the pharmaceutical companies, just in fairness.

Ms. Fowler.

[Elisabeth Fowler]

Yes. I mentioned in my presentation that our funding is one-third basically: one-third pharmaceutical company, one-third government, and one-third not-for-profit health charities.

[Wayne Marston, NDP, Hamilton East—Stoney Creek, ON]

Great. Thank you for that.

I appreciate the directness because--

[The Chair, Conservative, Rob Merrifield]

We have another answer here.

[Linda Tennant]

I'm completely retired and don't receive any money from any company at all.

[David Bougher]

And I'm in a similar position.

[Dr. Joel Lexchin]

I had a piece of cold pizza at a drug lunch 10 years ago.

[Voices]

Oh, oh!

[The Chair, Conservative, Rob Merrifield]

So what you're saying is you're on the take.

[Wayne Marston, NDP, Hamilton East—Stoney Creek, ON]

I think it's important and fair to the process to have that out there, and I want to thank everybody for that.

[The Chair, Conservative, Rob Merrifield]

Dr. Miyasaki.

[Dr. Janis Miyasaki]

I did mention I'm a clinical investigator, so my research unit has received money to conduct clinical trials. I have also received consultancy fees from the Ontario drug benefit program, the CDR, as well as having consulted to various American government agencies for free.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

[Wayne Marston, NDP, Hamilton East—Stoney Creek, ON]

I appreciate that now we've got all the cards on the table, because one of the previous speakers was speaking to Quebec, the efficiency that's seen down there and the number of drugs that are available. And it jumped out at me when I heard the comment that this was also a province where a good number of pharmaceutical companies are located.

I'm just concerned that there's an underlying current here that could be interpreted as pharmaceutical influence in both of those cases. So I'm the type who likes to see things on the table, so to speak.

Dr. Lexchin, would you like to respond further, or do you feel you've completed that?

[Dr. Joel Lexchin]

There are anecdotes from various places that suggest that drug companies sometimes try to use their economic power to influence decisions. For instance, back in 1971, when Manitoba set up its public drug plan and its formulary, the reaction from the pharmaceutical industry was that if Manitoba went ahead and did that, the industry would have to think again about investment in Manitoba.

When British Columbia set up its reference-based drug system, regardless of whether or not you think it's a good or a bad idea, the industry again made economic threats with respect to setting that up.

There were anecdotal reports when I was on the drug quality and therapeutics committee in Ontario that economic benefits were being promised should certain drugs be listed on the formulary.

I don't have any direct evidence of what goes on in Quebec or what doesn't go on in Quebec, but I believe that the enhancement or the development of the pharmaceutical industry in that province is a key aspect of its industrial strategy. So the province may feel that by listing more products it will get more economic benefit.