Health Committee on Dec. 13th, 2016

[Jean-Denis Fréchette]

—which is the normal procedure. The PBO has never done it for a study for a committee, as I mentioned before. The library did, in the past, have some contracts. I believe it was IT contracts or something that they had to send for approval in principle, which is part of the briefing book that the library prepares and that I prepare for the Speaker every time there is a new Speaker. Approval in principle means we have to review it. It's part of the normal procedure of my signing authorities.

[Rachael Thomas, Conservative, Lethbridge, AB]

Okay. I'll speak to my colleagues now.

Given that this study could cost definitely $100,000 and up, would it not make sense to bring the minister in at this point and ask for further direction with regard to the formulary, so that we're giving her information that her department would seek to know? Would it be possible to bring her to the table or to request that she write us a letter with some further direction? I'm not opposed to spending money, but I'd like to spend money in the right direction, so that we come up with a product that her department is going to find useful.

[The Chair, Liberal, Bill Casey]

I think that she would respond to any request like that. She's very interested in this. It was our choice to make this study, but she's interested in it, I know. I think there will be a very co-operative attitude in the department and in the government to see where this goes, because we've had estimates from zero to an $11-billion saving per year. If you talk about saving an average of $5 billion, $6 billion, or $7 billion a year, this is a very small amount of money.

[Rachael Thomas, Conservative, Lethbridge, AB]

Thank you, Bill.

I'm looking for some action on this. We can all leave here today, but then nothing will have been accomplished, so could we agree to write a letter to the minister asking for some information with regard to where she'd like to see this study go, on the type of formulary that she would like to see followed?

[The Chair, Liberal, Bill Casey]

I'd suggest we write a letter to her explaining what the PBO has proposed and see if she agrees with that.

[Rachael Thomas, Conservative, Lethbridge, AB]

Normally that letter would be written by the chair and submitted through the chair, but it would need the recognition of this committee to move forward with that.

[The Chair, Liberal, Bill Casey]

That's fine with me.

Now we still have Ms. Harder's time.

[Don Davies, NDP, Vancouver Kingsway, BC]

I have a point of order. With all due respect to Ms. Harder's time, which she can continue if she wants, I'm unclear where we're at in this. Ms. Harder seems to be asking a question of our colleagues to discuss. Do you want to have that discussion now, or do we want to have that maybe in committee business afterward?

[The Chair, Liberal, Bill Casey]

It's actually committee business.

[Don Davies, NDP, Vancouver Kingsway, BC]

Can we defer that question, then, until committee business? I'm asking because I have some views on that on what the question is.

[The Chair, Liberal, Bill Casey]

Yes, we'll defer it until committee business.

Now your time is up, Ms. Harder.

Go ahead, Mr. Kang.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Thank you, Mr. Chair.

My question is around the cost of $100,000. You want to get the data, and there were some other costs. Were there any problems you had in deciding what data to get, or was there any pushback not to get the data?

[Carleigh Malanik]

In our discussions with the data holders, QuintilesIMS, it hasn't been really so much pushback as a dialogue around what data is available and how we could receive that data.

I would just like to put out a general statement there that the data that we're requesting does allow for some flexibility around sensitivities. Right now we are moving forward with applying a Quebec formulary, but there would be potential to actually use a different formulary, so I just thought I'd add that.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

I hear that some of the data is old. How reliable will the data be that you are getting? Is it pretty up to snuff, or...?

[Carleigh Malanik]

Right now it's our understanding that we would have data available for a full calendar year for 2015. If we wished, we could get partial 2016 data, but I think we're going to look towards the 2015 calendar year. This would include data from the Canadian Institute for Health Information for the same year as well.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Okay.

My understanding is that you'll be basing this on the Quebec formulary. Is the Quebec formulary the Cadillac model or the middle or lower model? Will it be implementable? If we use their model, cost-wise, is the Quebec model covering all the drugs in general that Canadians will need? That's my concern on the Quebec model. Will we have to add drugs to that formulary or maybe take some drugs off the formulary?

[Carleigh Malanik]

We haven't started the detailed analysis comparing the different provincial formularies. We're right now just running with a Quebec formulary, but again, the data that we're purchasing will allow for application of additional formularies, and it's in the plan for a sensitivity analysis to at least understand what Quebec's formulary is compared to other formularies with the list of drugs and things like that.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

So this will be a kind of step in the right direction and not the final approach?

[Carleigh Malanik]

No. Our project will be based on using a Quebec formulary. We will of course look at what that formulary means in terms of how many drugs are being covered compared to how many are being sold in Canada and things like that, but we based all of the calculations on the Quebec formulary.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Okay.

Can you make the technical methods available to the committee—for example, the methods for the estimates—once this is decided? Can you share all that information with the committee?

[Carleigh Malanik]

I'm sorry. Could you repeat the question?

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

In terms of all the methods you will use to come to certain formularies and costs, will they be shared with the committee before the final document comes out?

[Mostafa Askari]

To be clear, our reports, whenever we do a costing, have a section at the end, normally in an annex, which explains the methodology we have used, the data sources, and any other thing that is related to the report. We do not typically provide a daily update or monthly updates on those kinds of things. Once we have a clear direction through the terms of reference, we do our report and then submit the final report to the committee.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Okay.

We talk about jurisdictional issues with provinces and territories. What kinds of challenges do you think we're going to face when we come out with pharmacare? Have you given it any thought?

[Mostafa Askari]

Jurisdictional issues in terms of the provincial jurisdictions, do you mean?