Health Committee on May 16th, 2016

[Nick Whalen, Liberal, St. John's East, NL]

In the membership of the unions that you've been involved with—and I know that you're retired from it now—would you see an openness and a willingness on behalf of the union movement for a dollar-for-dollar reduction in compensation paid to members if that amount was picked up on the universal pharmacare side in terms of benefits being paid through that amount? Governments who are paying nurses and public sector employees could say, “We no longer have to provide this compensation. You no longer have to pay 50% coverage. We're going to take all that in, but we're going to drop your incomes as a result to pay for the universal national pharmacare program.”

[The Vice-Chair, Conservative, Len Webber]

Can I just interrupt you? You do have less than a minute now. I don't know if you want to—

[Nick Whalen, Liberal, St. John's East, NL]

We'll get that answer, and then—

[The Vice-Chair, Conservative, Len Webber]

Okay, sir.

[Julie White]

Sorry, you're asking me to say how all these various unions would consider this idea. I can't honestly speak for them directly. The only thing I can say very clearly is that all the major unions in this country are in favour of moving to a full public national pharmacare program.

You are asking me whether they personally will be prepared to pay for it? Well, many of them would actually get money back if they were not contributing these amounts to drug plans, so there is some wiggle room there.

[Nick Whalen, Liberal, St. John's East, NL]

Thank you.

[The Vice-Chair, Conservative, Len Webber]

Mr. Eyolfson, you've got seven seconds. I don't know if you can have—

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Seven?

[The Vice-Chair, Conservative, Len Webber]

Seven seconds, and now we're down to three.

I'm sorry, we'll have to move on from there.

We'll move on to Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Eisenschmid, does your association believe that a universal single payer in a public pharmacare system would reduce dispensing fees for pharmacists?

[Perry Eisenschmid]

It may or may not. It's possible.

[Don Davies, NDP, Vancouver Kingsway, BC]

Okay. You don't take a firm position on that?

[Perry Eisenschmid]

No.

[Don Davies, NDP, Vancouver Kingsway, BC]

You've referred to the report your organization commissioned entitled “Pharmacare Costing in Canada” intermittently throughout your testimony, and you called it research. You referred to “experts” in the field and “putting the facts on the table”. That study was not peer reviewed, was it?

[Perry Eisenschmid]

No, it was not.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Emberley, you're a pharmacist yourself?

[Dr. Philip Emberley]

That's right.

[Don Davies, NDP, Vancouver Kingsway, BC]

You're a man of science. Would you agree with me that.... Should the committee consider consultancy reports to be as credible as peer-reviewed papers?

[Perry Eisenschmid]

Can I answer that?

[Don Davies, NDP, Vancouver Kingsway, BC]

I'm asking Mr. Emberley; he's a pharmacist.

[Dr. Philip Emberley]

I refer to peer-reviewed studies in therapeutic areas, and that's where peer review is very important. This was a research paper that was done on the subject of cost, so I don't really see how they would be similar.

[Don Davies, NDP, Vancouver Kingsway, BC]

But isn't it part of the scientific method that peer-reviewed research is considered to be a staple in coming to an accepted scientific—

[Dr. Philip Emberley]

When you're dealing with science, yes it is.

[Don Davies, NDP, Vancouver Kingsway, BC]

Okay.

We're hearing wildly different figures. Some groups say that national pharmacare will cost Canada $6 billion a year, as your report says. Others say that going to a national pharmacare system will save us billions of dollars a year. I'll tell you that the latter is contained in peer-reviewed research. In fact, Dr. Steve Morgan's article entitled “Estimated Cost of Universal Public Coverage of Prescription Drugs in Canada” was just named the Canadian Institutes for Health Research's article of the year last week, and that was following a lengthy adjudication process by health policy researchers, professionals, and policy-makers.

I'm just wondering if we should discount that and instead place more emphasis on your report, which was not peer reviewed. Help me out. Where are the credible numbers?

[Perry Eisenschmid]

There are two things, and I think Phil touched on this. Peer review is very important for scientific journals, and when you're talking about medicine and therapeutics, peer review, when it comes to economic analysis, is more around research methodology, but they don't really typically question the assumptions built into that. When there's a fundamental difference between the costing study that we did and the Morgan study, it's all around the assumptions—for example, the exchange rate.

Do I think our study has credibility? I do, because unlike Professor Morgan, who has no real-world experience, our researcher actually worked in the federal government and worked with PMPRB. He's actually lived in the real world.