Health Committee on Feb. 14th, 2013

[Dr. Bradley Dibble]

In my experience within cardiovascular medicine, I think there's very good collaboration. In one way we're unique because more people die from our diseases than anything else, so we get to do a lot of studies on these patients. Clinical trials are always coming out. As a result, for example, I'm connected to CIHR, and I'm invited sometimes to participate in clinical trials if I would like.

It's very easy to be connected internationally because we're constantly getting information, usually by Internet or e-mail from all our organizations, the Canadian Cardiovascular Society, and then, in the U.S., where we tend to be members, the American Heart Association and the American College of Cardiology. We're told exactly what's going on with these clinical trials, when they're starting, when they're going to finish, and if we want to get involved, we know whom to contact.

Within cardiovascular medicine, I would say the global community has a lot of collaboration. Most good trials that answer the questions I have about how to better serve my patients tend to be multinational trials. Very few trials are done now in one community or even one country, because the question across the pond will be whether or not it applies to their patients. So these tend to be multinational, and they tend to have many thousands of patients. You can't do that without that level of collaboration.

[Dr. Rob Ballagh]

I'll take it to a micro level, and that is because I've just finished being the president of medical staff at my hospital. As such, I sat on the board of the hospital, and I also sat on the medical advisory committee, where we have to look at all the research proposals that come across the desk. You might not realize that a hospital the size of ours would do a lot of research, but we do a whole lot of research, and we do a lot of multi-centre research, particularly in our oncology area, our cancer treatment area, that comes out of the city, that comes out of Sunnybrook Hospital or Princess Margaret Hospital.

One interesting thing is that when a research study is proposed, it has to go through our research ethics board, and it's gone through the research ethics board of Sunnybrook. Of course, these are very important steps, because we want to make sure that all research is ethical, but you can imagine that if there are 20 hospitals, it would have to go through 20 boards before that research gets off the ground. Sometimes we can streamline these things with technology. I think there should be some way we can streamline these things so that they can go through boards in hospitals, not just in our country, but perhaps elsewhere. Multi-centres should not just be in small places like Ontario, but in the whole world.

[Patrick Brown, Conservative, Barrie, ON]

Another thing that came to mind with health innovation is the role it plays as a job creator as well, especially with technology. Obviously, better access to health care is the major benefit to our citizens, but there is a huge job component to this too, and I'd be interested to get your input on that.

I think of the example in Barrie, where the company Southmedic had a novel medical device that is produced in Canada; previously it was produced in China. They were able to make a superior product that is being used across North America. Southmedic is just one company.

You mentioned your experience as a resident, where it was challenging. What types of opportunities do you think we're missing in having a regulatory process that, as you described it, is burdensome? What opportunities would exist for Canada if we were to create an environment that would make medical devices easier to get to market?

[Dr. Rob Ballagh]

It's such a huge topic and my experience is longer than a one-minute or two-minute question.

What I would say is that to take an idea from the bench to the marketplace, to a drug with a label on the counter at your pharmacy, costs $1 billion today; it costs between $750 million and $1 billion. My product, had it come to fruition, would have seen that kind of an investment. At each step of the line there are regulatory processes. Some of them are easier to get over than others. It's a very important process to go through. There are similar processes in every other country that has patents. For me and for my company, our stumbling block was at the third or fourth step, when we were doing some proof of principle. We had to get a partner. We had to partner up with a company. That's where our stumbling block occurred; it was in that process.

Having help with those technology transfer issues, and certainly in the patent area, is where we could have great improvements in this country.

[Patrick Brown, Conservative, Barrie, ON]

You don't think Canada is behind other industrialized countries in terms of the regulatory process that exists? It's a lengthy process in all these countries today?

[Dr. Rob Ballagh]

I don't think we're behind, but I think we could be leading. We have some of the best doctors and some of the best scientists in the world in our country. That's one thing where I think we could, as a committee of innovators, be leading.

[Patrick Brown, Conservative, Barrie, ON]

Thank you.

[The Chair, Conservative, Joy Smith]

My goodness, I have to say it's been an extraordinary afternoon. What strikes me is your humble attitude, and that's everybody, the two doctors especially. I'm quite amazed. I can see why you're leaders in this field. What you say is very important.

We're putting a report together, and all the good work and good ideas from all our witnesses will be part of that report. We have a long way to go yet because this has been a technological innovation. It's been an extremely important study that we've done.

Have a great Valentine's Day. Don't forget your spouses.

Have a good evening.

Thank you.