Evidence of meeting #19 for Health in the 42nd Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was medication.
A recording is available from Parliament.
Conservative
Rachael Thomas Conservative Lethbridge, AB
I'm not saying whether or not they're approved, whether or not they work—
President, Canadian Generic Pharmaceutical Association
—provincial drug programs review them, put them on the formulary, and pay for them because they work and are effective. Seven out of 10 prescriptions—
Conservative
Rachael Thomas Conservative Lethbridge, AB
So 100% of patients are positively affected by generic drugs? They work for 100% of patients to take away the symptoms of their health concerns?
President, Canadian Generic Pharmaceutical Association
Generic drugs are equivalent to the originator products.
Conservative
President, Canadian Generic Pharmaceutical Association
I cannot comment on this specific case.
President, Canadian Generic Pharmaceutical Association
But they are equivalent. They are approved by the federal government and provincial governments, and all payers.
September 22nd, 2016 / 9:55 a.m.
Conservative
President, Canadian Generic Pharmaceutical Association
Medical doctors and pharmacists trust them every day in Canada.
Conservative
Rachael Thomas Conservative Lethbridge, AB
If we, as a country, were to go entirely to generic pharmaceuticals, would the condition of every single patient across this country be adequately cared for?
President, Canadian Generic Pharmaceutical Association
That's not realistic. New medicines are very important, as Mr. Casey said. They are protected by patents for 20 years. During that time, generics cannot be sold. After patents expire, after companies have had an opportunity to recoup their investment and invest in new medicines, generics come on the market. They are approved by Health Canada. At that time, that's when I say generics should be used to the maximum possible.
President and Chief Executive Officer, BIOTECanada
Thank you, Mr. Chair. Thank you for the question, Ms. Harder.
I think your question points out something really important: it's not necessarily the therapy; it's the people. People are very complex. They react differently to different molecules, to different treatments.
Mr. Keon's point is correct. Health Canada regulates for safety and efficacy. In all cases, generic drugs are safe and efficacious. However, sometimes you put different therapies into different people and they react differently. That raises a very important point, one of subsequent entry biologics or the biosimilars. While, yes, they are all deemed safe and efficacious by Health Canada, they are very complex molecules and they will behave differently in different people. That's why the physician-patient dialogue is an extremely important one.
I cannot comment on the specifics of the case you mentioned, but I think that it would be one where you have to better understand what the physician is also seeing.
Conservative
Rachael Thomas Conservative Lethbridge, AB
If we were to move toward a pharmacare program, I think the point I wish to make here is that oftentimes with a pharmacare program we end up using generic drugs because they tend to be cheaper. That's where governments tend to invest their money.
However, I think the point needs to be noted that often they're not as effective as other drugs. This means we are putting patients in a scenario where, yes, some of their drugs are going to be covered by a public plan, but they are still going to have to pay out-of-pocket when those generics are not effectively useful for them.
I'm not looking for a comment on that; I'm actually looking to let my statement stand.
My next question here would be with regard to BIOTECanada. I'd like you to comment on whether or not a pharmacare program would, in fact, advance innovation with regard to your industry.
President and Chief Executive Officer, BIOTECanada
It absolutely could; it depends on how it's designed. The complexity of our industry is one where you have small innovators that have a great idea and they're trying to move it forward, but they need partners. They need investors. A lot of those partners and investors come in the large multinational companies that are doing business here.
It's very easy to look at a drug and the cost of a drug and say you're going to cut it by x% because you know exactly, when you look at the ledger, what you're going to get in savings. In so doing, though, you also miss out on some of the other parts that are impacted by the industry.
As Mr. Keon points out, you cannot have a generic industry without the innovator industry. That's the key sort of relationship that needs to take place. You need those innovators to be healthy and contributing to the ecosystem that we have not only in Canada but around the world, because that is what will drive innovation forward.
The industry has fundamentally changed over the past decade. They used to try to do it all themselves. If you look at some of the companies, they used to do all the research, development—everything was in-house. They've now changed their model. They're going across the globe looking for those new innovations to fill the pipeline. They're finding it in the small companies that are in Canada, but also elsewhere.
That very interconnected relationship is very important to keep in mind when you're looking at something like a pharmacare program, because there will be consequences. As Ms. Hux pointed out, you have to weigh all of that to better understand what the impact is going to be.
Conservative
Rachael Thomas Conservative Lethbridge, AB
In your estimation, then, Mr. Casey, how would we go about protecting those originator organizations in order to make sure that we do, in fact, have innovation taking place?
President and Chief Executive Officer, BIOTECanada
The system is in place to do that already. It's working in a very healthy way. On the small molecule side, you have the patent protection that allows the generics to come in. We're moving to the same sort of system for the complex biologics. That's already there.
In a pharmacare system, I think the challenge is going to be—and you were pointing this out in your remarks—that if you move uniquely to one type, whether it's a generic or you limit access to a number of different innovative medicines, you're creating a marketplace that's not competitive with other marketplaces. We're talking about a global marketplace. It's nice to think of Canada as a nice, comfortable place to be, but we're actually in a global marketplace.
Similarly, you can't go to Fort McMurray and get gas for 10¢ a litre. The reason for that is you buy gas in the global marketplace. This is not dissimilar. It's even more complex because we're not a commodity. We're an innovative product.
If you look at the therapy as a commodity and treat it as such, you will have negative implications for the innovative side writ large.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you all for being with us here today.
Mr. Casey, I think you asked a profound question. You asked what we're talking about when we talk about pharmacare. I'm going to ask a general question, then. I'd like each of you to answer yes or no, and then I'll dig into it.
The evidence this committee has heard is that approximately 20% of Canadians don't have access to medicine they need when they're ill; about 10% have no coverage whatsoever, and another 10% of Canadians have such sporadic coverage as to effectively not have any at all. That's 7.5 million Canadians walking around our country today who cannot afford to buy the medicine they need to get well, even if it were prescribed by a doctor.
Do you support developing a system whereby every Canadian can get access to the medicine they need, regardless of their ability to pay?
Ms. Harris
Vice-President, Government Affairs, Canadian Federation of Medical Students
Yes.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you.
Ms. Hux, in a statement released by the Canadian Diabetes Association in September 2015, you're quoted as saying:
Over the last decade, complication rates from diabetes for major complications such as heart attack, amputation, and kidney failure have been cut in half. That improvement is almost entirely attributable to evidence-based medicines. Unfortunately, not all Canadians benefit from these advances.
I think you've elaborated on that today. In your view, what impact would a universal pharmacare program have on complication rates from diabetes?
