Health Committee on Sept. 22nd, 2016

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

The issue has come up about the very premise of this study, which is whether there are Canadians who do not have access to medicine. We have heard evidence of that impact.

Mr. Keon, I will start with you. You represent a major player in the pharmaceutical industry in Canada. Does your organization have any data or information to share with this committee on whether there are Canadians who can't afford their medicine?

[Jim Keon]

We have data on the utilization of medicines. Unfortunately, we do not have good data on people who don't take medicines and aren't covered. Our role in the system is to provide good, safe, quality medicines at good prices.

[Don Davies, NDP, Vancouver Kingsway, BC]

That is fair enough.

Mr. Casey, you are on the cutting edge of this. Are there people in Canada who can't get access, because of cost, to the kind of biologics and other innovative medicines that your industry is working on? Do you have any data to share with us on that? Is everybody getting the medicine they need?

[Andrew Casey]

I don't have any data. I would be hard pressed to come up with an answer to the question of whether everybody has access. I think that, for the most part, most do right now, but that is where the struggle is starting to happen. We start to see what is coming, and the payers recognize that they are barely managing the basket they have. How do they handle what is coming down the road? I think that is the challenge. I think that right now, generally, it feels like it's fine, but I think that what is coming is the bigger issue.

[Don Davies, NDP, Vancouver Kingsway, BC]

We have heard evidence that right now a lot of Canadians get whatever prescription coverage they have through their employers. Employer groups have testified here that many employers don't provide such coverage, or if they do provide such coverage, there are copayments and deductibles. In fact, a number of employers are struggling with the rising costs of these plans, and there is an increasing number of employers that are no longer providing prescription plans for their employees. There are spouses who are not working and live at home who may have only partial coverage through their spouse's coverage, and there are a lot of working Canadians who don't have any coverage at all. Does anybody dispute that?

[Andrew Casey]

I think it's a challenge. I'm an employer as well, obviously. We have people on staff and we go through a regular review with our insurance provider, and we see this challenge daily, even though we're only nine people, so I can only imagine what it's like for larger employers.

One point that I would mention as well is that there are some other drivers here. We've looked at it in a very narrow slice of treating somebody, keeping them out of the hospital, keeping the expense down, and saving the health care system. There is an important contribution to the employer as well. If you get individuals treated and get them back to work, the employer does benefit.

More importantly, what we do know about people is that if you are gainfully employed and contributing as an active employee, you're a healthier person generally. You feel like you're contributing to society and also, as a father, as a spouse, you're a better person at home. So there are a whole bunch of other parts to this that are very important to consider. I certainly know that employers and life and health insurance companies factor that into their decision-making; governments less so, for obvious reasons.

[Don Davies, NDP, Vancouver Kingsway, BC]

I have one quick question. The question of how we save money was raised. What's been identified at this committee so far is bulk buying, exclusive supply contracts, the savings from cost-related non-adherence, having a broad, independent national formulary, evidence-based prescribing, and streamlined administration. These are all features of national universal pharmacare plans that contribute to savings of money. In fact New Zealand—

[The Chair, Liberal, Bill Casey]

Make it a quick question, Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Yes, I'll get to it.

The quote is:

By tightly controlling the country’s formulary, [New Zealand] has been able to keep costs flat while drug use has risen. One study found that New Zealand paid 51% less than British Columbia for four large, established classes of prescription drugs.

I would just put it to the witnesses that there are real-life examples in the world right now of universal national plans that are saving money because of those factors.

[Andrew Casey]

May I comment on that one? That's a great one. I would sound a note of caution when we're thinking about all of this and looking at other jurisdictions, because you're entirely correct, but one of the ways they've done that is limited access. Their formularies include fewer of the therapies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Don't all formularies limit access to some degree?

[Andrew Casey]

Absolutely, but if you cut out 50% more than Canada does, you save. You just have to figure what that is. In your overarching comment, though, you did touch on the fact that it's an outcome. We need to look for better outcomes. There are a number of different ways to get there. We have to bring them all together so that the outcomes for the patients are better.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

[The Chair, Liberal, Bill Casey]

The time's up.

[Jim Keon]

Mr. Chair, may I respond very quickly?

[The Chair, Liberal, Bill Casey]

Thank you very much to the panel. You certainly gave us a lot of good information to sort through, and again, if you have any other information you want to provide us, send it to us and we will digest it.

Thanks again. I hope you have a safe trip home.

Okay, crew, we need to have a little time for committee business. Next meeting we're going to set some time for committee business, because we have some to do.

We're going to restrict opening remarks for the guests to five minutes from now on. Is that okay with everybody?

That's it.

Everybody, we need proposed witnesses for the opioid study.

Mr. Webber, Ms. Harder, we need witnesses for the opioid study, so please submit them as soon as you can.

[Rachael Thomas, Conservative, Lethbridge, AB]

Would you like to put a deadline in place for that?

[The Chair, Liberal, Bill Casey]

How about Friday?

[Rachael Thomas, Conservative, Lethbridge, AB]

Okay.

[The Chair, Liberal, Bill Casey]

That's tomorrow.

The meeting is adjourned.