Health Committee on May 30th, 2016

[Dr. Robyn Tamblyn]

Yes. I wouldn't wait 10 years, but I'd get really parsimonious about what's going to go in the value basket that's going to be free. Go for the gold on that. Have an international strategy for the orphan diseases, and I think you can see it.

We have people on home care. They can't sustain the burden of the 15 medications they're on. They have to go into hospital in order to afford their therapy. We have 5% of the people in our country actually accounting for two-thirds of the health expenditures. Really, it's a payoff for people who are on a lot of meds, can't afford them, and can't afford to live in the community, yes.

[Prof. Matthew Herder]

Yes, absolutely. The best evidence we have shows you would save money.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thanks to all of you.

[The Chair, Liberal, Bill Casey]

That concludes our normal round, but I'm going to ask the committee if they would like to have one round from each party for three minutes. We could fit that in.

Do we have—

[John Oliver, Liberal, Oakville, ON]

I have that one bit of business for the committee.

[The Chair, Liberal, Bill Casey]

Oh, you do? Okay.

[John Oliver, Liberal, Oakville, ON]

It doesn't necessarily have to interfere with that.

[The Chair, Liberal, Bill Casey]

Is it the committee's desire that we have one three-minute round for each party?

[Some hon. members]

Yes.

[The Chair, Liberal, Bill Casey]

Okay.

Ms. Sidhu, do you have a question? You haven't had a crack at this, so you have time for a question.

[Sonia Sidhu, Liberal, Brampton South, ON]

I'm going to pass. My question has already been covered.

[The Chair, Liberal, Bill Casey]

Okay.

No questions?

Peter, you always have a question.

[Peter Fragiskatos, Liberal, London North Centre, ON]

Yes, I do have a question.

Dr. Tamblyn, this is what I didn't get to ask you during my round of questioning. Obviously, you're a strong proponent of national pharmacare. Is there a particular state doing it now that you would point to as a model that Canada can learn from in terms of cost savings and in terms of how they do it? That's a huge question, and I understand that.

I understand that the committee has been looking at this. I'm sitting in for a colleague today, and this is a fascinating issue. That's why I wanted to raise the point.

[Dr. Robyn Tamblyn]

In terms of principles, of getting the best bang for your buck for your investment, I wouldn't turn to a nation. I'd look at something like Kaiser. Kaiser manages in such a way as to get the best bang for their buck. If you can emulate their principles in a national pharmacare program, I think you would be in great shape.

[Peter Fragiskatos, Liberal, London North Centre, ON]

Thank you very much.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Chair, on a point of order, I don't know what Kaiser is.

[Dr. Robyn Tamblyn]

Kaiser Permanente is a mixture of a health insurance and health care delivery in the U.S.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

[The Chair, Liberal, Bill Casey]

Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Dr. Tamblyn, I think that's a great idea on the adverse drug events. I mentioned Vanessa's Law and the safety component. What kind of doctor uptake and buy-in are you getting with this adverse drug reaction reporting? Do you have an update on how things are going with Vanessa's Law?

Professor Herder, do you?

[Dr. Robyn Tamblyn]

We have mandatory disease reporting for infectious diseases like malaria and such, and we still have a reporting problem, with 5% reported and 95% not reported, so I think mandatory reporting is not going to be the solution if we really want to have.... I want to keep track of all those adverse events, so here's the idea behind what I'm proposing.

We're already going to put $50 million into a national prescribing system, so why don't we make it a feature component to include drug stop orders and mandatory documentation on the reason for the stop order and the problem that ensued, which would be important for patient safety and important for our proactive monitoring system? That would be good for patient safety, and we will actually get information on a much faster, broader scale than we will only with adverse drug reaction reporting.

That's what I'm proposing. It does work, because it's important therapeutically and important for patient safety. We have an opportunity here.

[Colin Carrie, Conservative, Oshawa, ON]

Would patients have any input in there, or would it be just doctor centred?

[Dr. Robyn Tamblyn]

Actually, because we have a prototype of a system like this in Canada, for the most part, half the time a druggist stopped us because the person had already stopped it, and they come to their practitioner and say that it isn't working, that they had a big rash, or had uncontrolled nausea, and so they took themselves off it. So the physician dutifully records it so that they know that they shouldn't be prescribing that drug yet.

[Colin Carrie, Conservative, Oshawa, ON]

Yes, but the doctor uptakes to actually report that—

[Dr. Robyn Tamblyn]

Well, in fact, we could actually set it up so that patients could do the same thing, even better.