Evidence of meeting #14 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was cost.
A recording is available from Parliament.
4:55 p.m.
Executive Director, Angus Reid Institute
Thank you very much to the committee for the opportunity.
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Liberal
4:55 p.m.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
Very quickly, I have more a statement to make to Dr. Dutt.
I'm an emergency physician. I did that for 20 years, and what you said about emergency physicians dealing with patients who can't afford their medications is true. I spent 20 years encountering that. You nailed the point as to what a problem it is in that environment.
It's actually one of the things that pushed me into this line of work.
4:55 p.m.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
My first question was asked by Ms. Harder. I was wondering the same thing as she, and I didn't quite understand your answer to it. In your previous incarnation as Canada's Research-Based Pharmaceutical Companies, your commitment was to 10% of profit to R and D, and it's now only 4%. Please explain again why it's now 4% when it was 10% before.
4:55 p.m.
Vice President, Innovation and Health Sustainability, Innovative Medicines Canada
The change from the 10% commitment in 1986—and we had to dig up the agreement letter with the federal government on it—
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Vice President, Innovation and Health Sustainability, Innovative Medicines Canada
—was defined in a specific way so that the terms and conditions and the business practices would remain substantially the same. What has occurred over time is that drug development has evolved dramatically. It's much more international than it used to be and much more focused on international clinical trials.
The PMPRB still records R and D spending based on the same 1986 premise, but what has happened is that the tools for investment, infrastructure, etc., that were going forward have been reduced over the course of time. What has gone up significantly are investments in international clinical trials and, as I mentioned in my previous answer, we have over 9,000 trials going at any given time. If those trials are sourced out of Canada as the original research, even though Canadian sites are involved, none of the money spent, literally the hundreds of millions of dollars spent on that, gets counted or credited to our members for R and D that actually is occurring in Canada.
4:55 p.m.
Vice President, Innovation and Health Sustainability, Innovative Medicines Canada
So it's an understatement of what's going on, really based on what has changed in drug development over time.
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Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
Sorry to cut you off, I have limited time here. So what you're saying is that this is money you are investing but isn't being counted.
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Vice President, Innovation and Health Sustainability, Innovative Medicines Canada
Correct, and it's significant.
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Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
All right.
There's been a lot of criticism, Mr. Skinner, of some of your writings, some done with the Canadian Health Policy Institute, and from other witnesses we've had, that really disputes the Morgan study. Now we've talked about how—and Dr. Dutt made references to it as well—this was peer reviewed research, quite rigorously studied and evaluated. What was the peer review process of the data that generated the numbers in what you've put forward?
4:55 p.m.
Executive Director, Health and Economic Policy, Innovative Medicines Canada
I'm here to answer questions on behalf of the Innovative Medicines Canada organization—
4:55 p.m.
Executive Director, Health and Economic Policy, Innovative Medicines Canada
—not on behalf of my independent research. But I'm happy to address the question anyway.
The study was done by me and three colleagues through the think tank that I'm the CEO and founder of, the Canadian Health Policy Institute. All of the data sources are explicitly referenced in the study, and all the methodology is explicitly laid out in the study. We have an internal and an external review process, and then we publish our work and put it in the public domain ultimately for scrutiny by other academics and people in the policy community.
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Executive Director, Health and Economic Policy, Innovative Medicines Canada
We took a somewhat different perspective from the Morgan et al paper that was published in the CMAJ. We did not see that there would be, in fact, savings for taxpayers under the scenario of a national universal government-run monopoly approach to pharmacare. We saw that there would be substantial costs to absorbing current private sector expenditures on pharmaceutical-related costs, and that if those were absorbed under a federal plan, it would mean that $25 billion would added to the federal budget. If it were absorbed simply—
4:55 p.m.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
Okay, thank you. You answered that question, thank you.
The last question is for Mr. Monteith and it's on public versus private schemes. In public insurance schemes, what proportion of patients are turned down for coverage for pre-existing conditions? Do you know that?
5 p.m.
Vice President, Innovation and Health Sustainability, Innovative Medicines Canada
To my knowledge, none.
5 p.m.
Conservative
Len Webber Conservative Calgary Confederation, AB
I'd like to ask a few questions of our celebrity panellist here, Mr. Romanow.
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Commissioner and former Premier of Saskatchewan, Commission on the Future of Health Care in Canada, As an Individual
I thought you were referring to Marchildon.
5 p.m.
Conservative
Len Webber Conservative Calgary Confederation, AB
No, I was referring to you. It's a pleasure to have you all here.
