Health Committee on May 13th, 2008

[Robert Thibault, Liberal, West Nova, NS]

One minute, okay.

The question I have is on the national pharmaceutical strategy. I'd like to leave the other question about the generics, the innovators, and patents alone for now. I know it's being looked at by the industry committee.

But on the national pharmaceutical strategy, one of the perennial demands of the Canadian public has been for a national pharmacare program. We understand there are huge amounts of money needed to get there, but part of the strategy has some intermediate steps that we could look at. One is the drugs for rare disorders, and the other is the catastrophic cost of drugs, where you have people with diseases or ailments that require them to spend 30% or 40% of their revenues—

[The Chair, Conservative, Joy Smith]

Mr. Thibault, will you get to the question? You're out of time.

[Robert Thibault, Liberal, West Nova, NS]

Yes.

Have you dealt with that as it was supposed to be dealt with?

[Russell Williams]

We are quite eager to work....

We want to work hand in hand with governments. As for catastrophic coverage, we find it unacceptable that access to medications is not the same from one region to another in this country. We are ready to establish a partnership with provincial governments. We must have a national approach while respecting the provinces in whose jurisdiction the matter lies.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Williams.

Madame Gagnon.

[Christiane Gagnon, Bloc, Québec, QC]

Thank you for being with us today.

I would like to talk about the question of First Nations' health. The federal government has a very specific clientele. The Wait Time Alliance and the Canadian Healthcare Association have looked into this. According to the Canadian Healthcare Association, it is impossible to know what advances have been made. It is not clear. We do not know if funds have been allocated. People bring up infant mortality and youth suicide, but we do not have a lot of data. In 2000, the Auditor General made very specific recommendations. All the shortcomings were highlighted. How can it be that, in 2006, no concrete results had yet been obtained?

Earlier, we were talking about the lack of human and financial resources. As we know, this is a federal responsibility. Do you not think that, if the federal government had good results with its own clients, it could show the way. Do you not think that the serious shortcomings identified by the Auditor General for the First Nations would give the provinces a clear idea of the situation? We ask them to give us their reports, their data. Getting a Cin the 10-year plan is not very convincing.

I would like to know why we are not getting there. What resources do we not have? Have you looked into it? Has the Department of Health looked into the shortcomings in First Nations' health? I would like to put that question to the Wait Time Alliance and to the Canadian Healthcare Association.

[The Chair, Conservative, Joy Smith]

Perhaps we should get right to the answer, Madame Gagnon.

Who would like to answer that question?

Madame Fralick?

[Christiane Gagnon, Bloc, Québec, QC]

I asked the Alliance and the Canadian Healthcare Association.

[The Chair, Conservative, Joy Smith]

Dr. Bellan.

[Dr. Lorne Bellan]

I guess what I'll say is that your question highlights the general issue of lack of data collection. It's very hard for us to comment specifically about aboriginals or any other specific sector. It's hard for me to break it down into geriatrics versus youth. And it's partly because of the inadequate reporting of all aspects of health care that we have in the country. So I think one of the lessons we've learned from the initial efforts is that it's been tremendously useful to gather and report data, because then you can identify what the problems are and where you want to go next in the solution. But in the absence of any of that data being gathered, you're just making a guess.

I can't give you a more specific answer to your question about aboriginals because.... We get our data from the provincial governments or from the federal government, and there aren't even databases that we can turn to right now to answer your question. So the first step is to get those databases created.

[The Chair, Conservative, Joy Smith]

Go ahead, Madame.

[Christiane Gagnon, Bloc, Québec, QC]

I am also going to put the question to the Canadian Healthcare Association.

What recommendations would you like to make to Health Canada in terms of gathering data? What tools do you need to study the situation? That clientele is in federal jurisdiction. That could give a clearer idea of the steps needed that you cannot get at the moment.

[Pamela Fralick]

Thank you.

The members of the Canadian Healthcare Association have not discussed aboriginal issues specifically, but I would support the comments made by my colleague that without the data, we can't do anything, regardless of which population it is. So I would certainly support increasing our data.

If I could give one quick example, we know from the Canadian Institute for Health Information that they focus tremendous energy on gathering data on physicians and nurses. Only in the last couple of years have we turned our attention to other health professionals.

So we simply don't know. It is a most unfortunate situation.

If there could be more resources put into any one area around the HHR side of things, I would certainly highlight that as one of the top priorities: we need to understand the problem before we can evaluate and come up with solutions.

[The Chair, Conservative, Joy Smith]

Now we'll go to Madam Wasylycia-Leis, please.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Thank you, Madam Chairperson, and thanks to all of you.

Let me start with Russell Williams, on this issue of the gazetted changes with respect to notice of compliance.

Did you have any discussions with the government on these regulatory changes proposed in the Gazette on April 26?

[Russell Williams]

We had no consultations on these amendments.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

You had no discussions at all with government prior to this being gazetted?

[Russell Williams]

That's what I just said.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Jim Keon, did you have any consultations with government?

[Jim Keon]

No. We've said many times we were very surprised and very disappointed at the short consultation period.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Mr. Williams just accused you of fear-mongering over this whole issue. It seems to me we are talking about serious issues--a national pharmaceutical strategy, national pharmacare--all of which are hampered by the lack of movement with respect to cheaper generic drugs getting onto the market.

Could you give us some sense of the impact of these regulatory changes that are being proposed?

[Jim Keon]

The topic I focused on today was faster access to non-patented generic medicines, which was one of the objectives of the national pharmaceutical strategy of the 10-year health care plan. As I mentioned, the provinces have taken a number of measures to do that. Where the problem has come in is at the federal level.

I would say the generic industry in Canada is a real success story. We have jobs, exports. We do double the R and D of the brand-name companies, and we provide about half of all prescriptions in Canada.

We have a very long way to go, however, because in the United States generics are now filling 67% of all prescriptions. We're filling only 49% in Canada. Our industry, our sector, has a very long way to go to provide what it's doing.

The current changes are going to extend monopolies that run directly counter to the changes that were made in October 2006 and confirmed by the Supreme Court of Canada. We're, frankly, very surprised and disappointed. We think the government should probably pull those out and have a broader debate about pharmaceutical patent policies. That's what they want to do.

[Russell Williams]

May I respond?

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

I would just like to ask another question, and then I'll get Jim and you, Mr. Williams, to respond.

What impact will this have on a province like Manitoba, which recently put out a press release talking about the savings it might incur as a result of a number of drugs going off patent?

[Jim Keon]

The net effect is it delays the generic products from coming on the market, and the impact, of course, is that you have to pay the higher prices for much longer. On some of the large-selling drugs, you're looking at tens of millions of dollars in a Manitoba drug program, and they will not get the savings from the generics for possibly two or more years longer.

Regarding the ability to put unrelated patents on a list at Health Canada and keep generics off, the Supreme Court said you shouldn't be able to do that. We thought that was the law, and the provinces were basing their estimates on that. Now all of that is being changed.