Health Committee on July 6th, 2020

[The Chair, Liberal, Ron McKinnon]

I call this meeting to order.

I'd like to welcome everyone to meeting 31 of the House of Commons Standing Committee on Health. Pursuant to the order of reference of May 26, 2020, the committee is resuming its briefing on the Canadian response to the outbreak of the coronavirus.

To ensure an orderly meeting, I would like to outline a few rules to follow. Interpretation in this video conference will work very much the way it does in a regular committee meeting. You have the choice, at the bottom of your screen, of the floor, English or French. As you are speaking, if you plan to alternate from one language to the other, you will need also to switch the interpretation channel so that it aligns with the language you are speaking. You may want to allow for a short pause when switching languages.

Before speaking, please wait until I recognize you by name, except during questioning. The questioner will generally indicate to whom the question is directed. When you are ready to speak, you can click on the microphone icon to activate your mike. I remind you that all comments by members and witnesses should be addressed through the chair. When you're not speaking, your mike should be on mute.

I would now like to welcome our first panel of witnesses. From the Canadian Center for Vaccinology, we have Dr. Scott Halperin, director of microbiology and immunology and professor of pediatrics at Dalhousie University. From the Canadian Generic Pharmaceutical Association, we have Mr. Jim Keon, president, and Mr. Peter Hardwick, chief commercial officer and executive vice-president of Apotex. From Innovative Medicines Canada, we have Ms. Pamela Fralick, president, and Mr. Dion Neame, country medical lead for Sanofi Canada.

With that, we will go to witness statements. Each group will have up to 10 minutes to make a statement.

We will start with the Canadian Center for Vaccinology.

Please go ahead, Dr. Halperin, for 10 minutes.

[Dr. Scott Halperin, Professor of Pediatrics and Microbiology and Immunology, Dalhousie University, and Director, Canadian Center for Vaccinology]

Good morning. Thank you for the invitation to meet with your committee and provide my thoughts about Canada’s response to the COVID-19 pandemic. I am speaking to you as an individual and I am not formally representing any particular group. I will spend most of my time describing the research group and the research networks I lead, since my message to you is reasonably short and the details of my research activities will provide you with greater context for the questions you may have for me.

I am a professor of pediatrics and microbiology and immunology at Dalhousie University. I am also a pediatric infectious diseases subspecialist at the Izaak Walton Killam Health Centre in Halifax, Nova Scotia. I have been in Halifax for 35 years, after growing up and undertaking all of my training in the United States. I spend approximately 25% of my professional time doing clinical work, 25% in teaching and administrative work, and the remaining 50% dedicated to vaccine-related research. My declarations are that I am a researcher and I receive research funds from multiple sources, including federal and provincial funding agencies, foundations and vaccine manufacturers. I also serve on federal and provincial government advisory bodies, and ad hoc industry advisory panels. One such federal committee currently is the Canadian immunity task force.

As part of my 50% research time commitment, I am the director of the Canadian Center for Vaccinology, or CCfV for short. CCfV is a research collaboration of investigators at Dalhousie University, the IWK and the Nova Scotia Health Authority. While primarily based in Halifax, CCfV also has investigators from St. Francis Xavier University and other Atlantic academic centres. CCfV is organized into three groups.

The discovery group comprises basic scientists, including virologists, bacteriologists and immunologists, with the goal of creating new and improved vaccines, new adjuvants and new vaccine delivery systems, and understanding the immune response to infectious disease pathogens. The discovery group is actively involved in COVID-19 vaccine development. It is establishing the animal model for COVID-19 infection and evaluating biomarkers of COVID-19 disease.

The evaluation group is made up of clinician scientists, epidemiologists and statisticians who do epidemiological studies [Technical difficulty—Editor]. As one of the primary vaccine trial sites in Canada, our group is busy preparing for multiple phase one COVID-19 studies.

The policy, programs and implementation group is our most diverse group, comprising nursing researchers, pharmacists, health economists, bioethicists and experts in health law, anthropology, psychology, pediatrics, internal medicine and public health. This group endeavours to understand how and when vaccines are used, understand attitudes amongst the public and providers, and evaluate the effectiveness of public health policy and programs. The PPI group has CIHR and SSHRC funding to explore the effects of public health COVID-19 policy on various communities in Canada and overseas.

As part of my research program, I am the nominated principal or co-principal investigator for two national networks relevant to vaccine research. The designation “nominated PI” is a term that designates a person as responsible for administering the network in a fiscally responsible manner and meeting the funder’s objectives. It does not imply that the person is the one doing most of the research, which in fact gets done by the co-PIs and co-investigators.

IMPACT, the immunization monitoring program, is a Public Health Agency of Canada-funded surveillance network administered by the Canadian Paediatric Society at 12 of the country's pediatric hospitals, accounting for 90% of the tertiary care pediatric hospital beds in Canada. IMPACT has been in existence for 30 years and it undertakes surveillance for selected vaccine-preventable, or soon to be vaccine-preventable, infectious diseases and adverse events following immunization that are severe enough to require hospitalization.

The second network is the Canadian Immunization Research Network, which is also called CIRN. CIRN was originally established in 2009 as the PHAC-CIHR Influenza Research Network, or PCIRN, to build Canadian research capacity in anticipation of a predicted influenza pandemic, which happened to be declared within one week of receiving funding. PCIRN was granted $3.5 million a year for three years, which was increased to $4.5 million a year when the pandemic was declared.

PCIRN was highly successful at undertaking rapid clinical trials of candidate pandemic flu vaccines, undertaking large-scale safety surveillance during the initial vaccine rollouts and establishing the safety of vaccination in individuals allergic to eggs, amongst many other studies. PCIRN was so successful that it was decided at the time of its renewal to expand its mandate from just influenza to all vaccines of public health interest, changing its name from “Influenza Research Network” to “Canadian Immunization Research Network” and cutting its budget in half from $4.5 million a year to $2.2 million a year.

Here's my first message.

While I'm very appreciative of the substantial research support for PCIRN and the continuing research support for CIRN, pandemics and emerging infectious diseases are not solved. They are mitigated and will continue to occur. Over the last 11 years, globally, the WHO has declared public health emergencies of international concern for H1N1, influenza, polio, Zika, Ebola—twice—and now, SARS-CoV-2. Cutting back on public health readiness between crises slows the response to the next emerging disease. While paying for readiness may seem wasteful and an easy target when cost-cutting is occurring, eventually a price has to be paid. Once the COVID-19 pandemic passes—and it will pass—we should not drop our guard in regard to pandemic research capability.

What is CIRN doing now, in the current COVID-19 pandemic?

CIRN is organized as a network that comprises eight subnetworks. These networks span the country. Over 100 investigators at over 30 institutions are members of CIRN. The CIRN networks are either actively engaged in the COVID-19 research response or are poised to participate once vaccine candidates are identified.

The serious outcomes surveillance network of adult acute care hospitals has already received supplemental funding to undertake COVID-19 surveillance at adult hospitals and collect specimens to understand how people develop immunity and biomarkers that might predict patients who develop severe disease.

CIRN's clinical trials network, which performed phase one and two studies on Canada's Ebola vaccine five years ago, is currently designing phase one and phase two studies for candidate COVID-19 vaccines. Over 10 groups have approached CIRN to undertake phase one studies for them, and five are in the active planning stage.

CANVAS, the vaccine safety network, is prepared to undertake broad surveillance to detect any vaccine-associated adverse events during the early phases of a vaccine's rollout. CIRN's social sciences and humanities network will examine the public's response to novel vaccines developed to prevent COVID-19.

CIRN's other networks, including the reference laboratory network, the modelling network, the special immunization clinic network and the provincial collaborative network will also be heavily engaged as vaccines become available.

What's going well with Canada's COVID-19 public health and research response?

I am very pleased with Canada's aggressive research response to this pandemic, with rapid calls for proposals and awarding of research funds. The tri-council competitions have been well publicized and well managed, and the amount of funding has been substantial. Could it be more? Sure. Given that virtually all research, except for COVID-19-related research, was brought to a halt in Canada because of the health restrictions in the workplace, including in universities. This means that all of Canada's research talent turned to focus on COVID-19.

Despite increased levels of funding, the success rate of grants at the granting councils did not rise, the scores required to be successful did not fall and research that received very high peer reviews still did not get funded. Message two is that Canada has a lot of talent, and if everyone focuses on a single topic, it takes a lot of money—even more than the impressive amount already committed—to fund all the projects that are worthwhile.

My next point is a bit beyond my scientific expertise and more of a personal observation. A key aspect of Canada’s successful public health and research response to the pandemic is that it has not become politicized. Canada, to date, has maintained the commitment to let the best scientific evidence guide its public health policy and research priorities. I think this is a critical factor in the control over the pandemic that we have achieved to date and our best effort to maintain control while awaiting a vaccine solution.

To close, while I don’t think there is anything that has gone poorly in Canada’s response, I do think there might be room for improvement. In the vaccine research and development arena, the process under way may have been more effective if there were a single person tasked to coordinate all of the activities required to bring a new vaccine into general use.

While all necessary activities are under way, some have been delayed, and information has not always been readily available when needed. There has been no single source for all information, or a directory to point someone in the right direction for answers about what are the required next steps. This leads to processes at times being established after actors in the field have already had to make critical decisions, leading to false starts and wasted time and effort.

A central clearing house established early in the pandemic in anticipation of vaccine development might have smoothed the process and made it more transparent to all involved parties. However, this is a criticism or suggestion regarding logistics in an otherwise very effective response to the COVID-19 crisis.

[The Chair, Liberal, Ron McKinnon]

Thank you, Dr. Halperin.

We go now to the Canadian Generic Pharmaceutical Association. I believe it's Mr. Hardwick who will speak.

You have 10 minutes. Please go ahead.

[Peter Hardwick, Chief Commercial Officer and Executive Vice-President, Apotex, Canadian Generic Pharmaceutical Association]

Good morning to you all. Hopefully you can hear me. I would like to thank the chair and honourable members for inviting the Canadian Generic Pharmaceutical Association to appear before the committee today.

In addition to my elected role as chair of the CGPA, I am the chief commercial officer and executive vice-president of Apotex, a Canadian-owned multinational pharmaceutical company and Canada's largest manufacturer of medicines.

CGPA president Jim Keon and I are pleased to have the opportunity to share our industry's response to the COVID-19 pandemic and highlight some of the ways that Canada can do more to ensure a sustainable and more resilient supply of prescription medicines for Canadians, moving forward.

Generic pharmaceutical companies are Canada's primary medicine manufacturers and exporters. CGPA member companies operate the largest life sciences companies and pharmaceutical manufacturing facilities in Ontario and Quebec. The industry directly employs more than 11,000 Canadians in highly skilled research, development and manufacturing positions. In addition to producing medicines for the Canadian market, made-in-Canada generic medicines are exported to more than 100 countries around the globe.

Our industry also plays a significant role in supporting Canada's health care system. Generic medicines are dispensed to fill 73% of all prescriptions in Canada but account for 19% of the $31 billion spent annually on prescription drugs. Up to 10 generic prescriptions can be filled for the cost of one brand-name prescription today.

From the outset of the pandemic, CGPA member companies have worked to provide support to our front-line workers. This has included donations of personal protective equipment and hand sanitizers, as well as financial supports for hospitals.

The industry has also provided support for potential COVID-19 treatments that are generic medicines. This has included two primary areas of focus. First, our industry has worked to secure a supply of generic medicines for these products to meet existing patient needs to ensure the continuity of their care. Second, our industry has donated tens of millions of tablets for use in Canadian and international clinical trials, and has expressed a willingness to retool our facilities and ramp up production for such products if they are found to be effective COVID treatments.

Our industry has also worked with governments, public health authorities, hospitals and international partners to help develop lists of essential drugs that are needed now and those that are needed for stockpiling in the event of subsequent pandemic waves. However, perhaps the most significant contribution by the generic pharmaceutical industry to Canada's COVID-19 response has been to provide Canadians with the medicines they need every day and to work to meet the new demands for hospital products and other products required to treat patients with COVID-19.

The pandemic has created unprecedented challenges and uncertainty for global supply chains in all industries, with border closures and export restrictions imposed by some countries and significant reductions in global shipping capacity. The pharmaceutical industry was not immune to these challenges.

Consider for a moment the sheer number of medicines we are dealing with. Generic pharmaceutical companies supply the Canadian market with hundreds of different medicines in thousands of different dosage forms. These products are used to fill three out of every four prescriptions. While many of these medicines are made in Canada, the industry is fully globalized. Finished products, manufacturing inputs and active pharmaceutical ingredients are also sourced internationally.

The CGPA is extremely proud of the dedication and hard work of generic industry employees to keep medicines in production in our manufacturing facilities and to keep medicines moving through the supply chain. They continue to provide an essential service for Canadians every single day, and we thank them. We would also like to recognize the important work of Health Canada and the trade commissioner service in helping our members address supply chain connectivity challenges, as well as the work of several provinces, distributors and pharmacists to help us ensure equitable access to the supply of medicines in a time of global supply chain upheaval.

The movement of all products internationally, including medicines, is much slower and more difficult that it used to be, and it is much more costly. While the situation has stabilized considerably, our industry is monitoring developments around the world on an ongoing basis to identify potential supply chain risks.

I will now turn the floor over to Jim Keon to provide our industry's recommendations from the lessons learned from COVID-19.

Thank you.

[Jim Keon, President, Canadian Generic Pharmaceutical Association]

Thanks, Peter.

I know the clerk has circulated to members a summary of the CGPA blueprint for a sustainable supply of prescription medicines for Canadians. The CGPA developed this blueprint based on some of the lessons learned during the first three months of the pandemic. It outlines our recommendations to make the prescription drug supply chain even stronger and more secure for Canadians.

The COVID-19 pandemic has served as a wake-up call for governments, health care professionals and the broader public on the importance of having a robust and resilient domestic pharmaceutical industry. In a recent interview with CBC Radio's The House, Deputy Prime Minister Chrystia Freeland noted that “one of the consequences of coronavirus is going to mean, for the economy, a shift from a sort of just-in-time, get-the-very-cheapest-input-possible model, to a model that puts a greater emphasis on resilience, puts a greater emphasis on supply chains that are closer to home”.

Putting a greater emphasis on resilience in the pharmaceutical supply chain will mean challenging the status quo and adopting new policy approaches. That is precisely what the CGPA is recommending.

The CGPA identifies specific measures to enhance Canada's existing pharmaceutical manufacturing capacity and domestic capabilities, create a more resilient pharmaceutical supply chain with increased supply redundancy, ensure Canada's role within a well-functioning global supply chain and encourage the establishment of a more coordinated approach to equipping Canada for future health emergencies.

I'm going to turn to our first area: strengthening the domestic pharmaceutical industry. Investments are needed to support Canada's pharmaceutical infrastructure. Companies will need assistance in preserving, refocusing and expanding domestic manufacturing infrastructure, and in increasing other infrastructure capacity such as warehousing. Companies may also require additional support to address the significant financial burden associated with maintaining higher stock levels of key manufacturing inputs and medicines.

The second aspect of strengthening the industry is increased regulatory convergence, both nationally and internationally. The reality is that Canada is a costly and complex jurisdiction for generic manufacturers to operate in. Removing unnecessary regulatory hurdles should be a priority.

The third aspect of this is pricing levels. “How low can you go?” pricing does not build resilience. A review of Canada's current pricing regime is needed to ensure that it is economically feasible to manufacture medicines in Canada and to be sufficiently competitive to acquire finished products and other inputs on the international market.

The fourth aspect of strengthening the market is strengthening the domestic industry. If the percentage of generic drugs used in Canada matched the current levels of use in the United States, Canada would save more than $11 billion annually.

The fifth aspect is that we are arguing for a sustainable domestic market for biosimilars to be implemented. This would involve maximizing the use of biosimilar medicines through broad implementation of well-controlled switching policies by public and private drug plans in Canada, including federal plans.

A second key area of our focus of the blueprint is securing and enhancing Canada's role in the international pharmaceutical supply chain. This could include, for example, the development of an international pharmaceutical supply chain security agreement, which is something we have recommended.

The third and final key area of focus in the CGPA blueprint is identifying essential generic medicines to domestically produce and stockpile for Canadian needs. A coordinated approach is needed among federal, provincial and territorial governments to establish a list of high-priority medicines. Building a domestic stockpile of these products would also require guaranteed volume and price agreements with companies.

The CGPA and its member companies look forward to working with Canadian governments and other stakeholders to turn the objective of a sustainable supply of prescription medicines for Canadians into a reality.

Peter and I would be pleased to answer any questions you may have this morning. Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you.

We go now to Innovative Medicines Canada.

Ms. Fralick, please go ahead for 10 minutes.

[Pamela Fralick, President, Innovative Medicines Canada]

Thank you, Mr. Chair and honourable members, for the opportunity to meet with you today.

I'd like to start by acknowledging the efforts of the entire federal government to fight the spread of COVID-19 and to protect our economy. As a Canadian, I'm proud of how our government has risen to the challenge. I've spent most of my working life in the health care sector. I can honestly say that the degree of co-operation we are seeing across governments, our health systems, industry and civil society is something I've never experienced, and Canadians will be better off for it.

I'm here today on behalf of Innovative Medicines Canada. IMC represents not just 40 companies from the innovative medicine and life sciences sectors, but also the tens of thousands of Canadians who work for them. Day in and day out, they dedicate themselves to ensuring all Canadians have the medicines they need, when they need them.

I'm joined today by one of them: Dr. Dion Neame. Dr. Neame is a country medical lead for Sanofi Canada and country medical head for Pasteur, the vaccine arm of Sanofi. He's also a pediatrician working in urgent care clinics. He's here not as a company representative, but as an expert in the field of vaccines who can answer any questions you might have about some of the COVID-19-related developments taking place in Canada and around the world.

I mentioned that our membership consists of 40 companies. Together they contribute $19 billion annually in economic activity and support 30,000 high-value jobs across the Canadian economy. They also invest 10% of their revenues, or $1.2 billion per year, into research and development in Canada. Currently, there are more than 500 new products, medicines and vaccines in development in Canada, including therapies focused on some of the most devastating illnesses like cancer, as well as rare and infectious diseases.

Today, though, there is no greater priority than the fight against COVID-19.

Our members are collaborating like never before to accelerate the discovery and development of treatments for people infected with the virus and of vaccines to stop its spread. Our members are also providing financial support and in-kind donations to organizations on the ground in Canada and around the world. They're maintaining patient support and compassionate care programs put in place by industry to help keep Canadians out of hospitals and reduce the burden on health systems, and they're working with governments and other stakeholders to help ensure that patients, doctors and hospitals continue to have access to the medicines they need on a daily basis.

Dr. Neame will now describe the activities our members are undertaking towards a discovery of a vaccine.

[Dr. Dion Neame, Country Medical Lead, Sanofi Canada, Innovative Medicines Canada]

Mr. Chair, for over 100 years, through innovation, altruism and collaboration, Canada has successfully responded to infectious disease outbreaks. From Dr. John FitzGerald and the University of Toronto preparing a diphtheria and tetanus antitoxin to vaccine researchers developing the freeze-dried smallpox vaccine, Canada's innovation has helped save millions upon millions of lives.

Today, during the COVID-19 pandemic, 15 IMC companies have opened up their libraries of molecular compounds to share with the global scientific community to spur the development of vaccines and treatments for the COVID-19 virus through the Bill & Melinda Gates Foundation COVID-19 therapeutics accelerator.

In just two weeks, Roche Canada received over 800 submissions from Canada's scientific community through its COVID-19 innovation challenge, a $900,000 funding program created to bring forward innovative ideas to address the pandemic. In Atlantic Canada, BioVectra is manufacturing critical raw materials for COVID-19 diagnostic testing kits and collaborating with multiple Canadian biopharmaceutical companies and researchers on COVID-19 therapeutic products. Quebec's Medicago is rapidly moving forward on clinical trials to assess the safety and efficacy of a candidate vaccine, and scaling up production. In British Columbia, Amgen is building on 20 years of experience in the field of therapeutic antibodies and is actively engaging in anti-COVID-19 therapeutic antibody discovery efforts.

In short, we are witnessing an unprecedented effort in terms of the financial commitment to, and accelerated research and development of, prophylactic and therapeutic treatments for COVID-19, while continuing to produce and supply medications for existing patients. The ingenuity, innovative, creative and collaborative spirit and commitment of our industry are a testament to our values and our sense of responsibility to our country—Canada.

[Pamela Fralick]

Thank you, Dr. Neame.

I would like to shift to a topic that I know is on the minds of many, and that's the potential for drug shortages as a result of COVID-19.

IMC's membership consists of the pharmaceutical companies that discover, develop and deliver innovative new medicines, that is, brand-name prescription medicines. Our members continue to be vigilant in identifying potential supply issues and are committed to working closely with Canadian governments to quickly identify solutions. We support the efforts of Health Canada in this regard. In the event of any anticipated delays in supplying the Canadian market with an approved medicine to meet expected patient demand, our member companies would, in full compliance with the law, report this to Health Canada, and it would be made public on the drugshortages.ca website.

If there is one area where the federal government could provide additional support, it is in the area of COVID-related hospital products. Specifically, there may be an enhanced role for the federal government to play in coordinating provincial requests for additional supplies of drugs to ensure that no province and no Canadian goes without the medications they need.

Speaking more broadly, we recognize that reliable access to medications depends on many factors. These include regulatory simplicity, timely approvals for new medications and the continued smooth functioning of global supply chains. In this regard, we support Health Canada's ongoing commitment to take steps toward a simpler regulatory regime. However, more needs to be done to quicken the approval of new medications. We applaud the efforts made by the federal and some provincial governments to protect medical supply chains serving Canada.

On the topic of regulations, we remain deeply concerned about the impact that amendments to the patented medicines regulations will have on Canadians' access to new medications. Industry's concerns have not been adequately addressed by the recently revised guidelines. Our concerns are supported by independent studies and by the delayed product launches as a result of the regulations. The regulations will also hurt Canada's ability to realize the Department of Innovation and Science's HBEST strategy and attract investment to our life sciences sector at a time when provinces such as Ontario and Quebec want to build capacity in this area.

Let me assure you that IMC members are sensitive to the increasing strain on health budgets. However, since the recent federal court decision removed a key pillar of the PMPRB's approach to price regulation, a fundamental rethinking of PMPRB's approach is now required. We remain keen to work with the federal government on alternative solutions to the proposed changes to the patented medicines regulations that would ensure that Canadians continue to have access to affordable, innovative medicines. It is not too late to find another solution to reach this objective.

To return to the industry's response to COVID-19, I'd like to leave you with three examples of my members' contributions.

First, some of our member companies are ensuring patients' continued access to the treatments they need by providing their medicines free of charge if patients cannot afford them or if they lose private prescription drug coverage due to COVID-related unemployment. On this point, I am able to report that based on feedback received from some of our members, there has in fact been minimal demand for free medication from patients. One of our members, for instance, reported that they have seen less than 2% of anticipated demand for free medicine. Others are reporting similar experiences. This suggests to us that there are far fewer people without access to the medicines they need than expected.

Second, with some provincial health care systems experiencing critical skills shortages, Innovative Medicines Canada member companies are stepping up to help patients and communities. Many of our members are providing paid leave to health professional employees, enabling them to volunteer in health care facilities, where the need is greatest.

Finally, IMC members have created a special COVID-19 fund. A key initiative created through this fund is the creation of a research chair in pandemic preparedness. This is industry's way of helping Canada prepare for the next health crisis.

Thank you again for the opportunity to talk with you about how Canada's innovative medicines and life sciences sector is responding to COVID-19. Like your other witnesses, we would be pleased to answer your questions.

[The Chair, Liberal, Ron McKinnon]

Thank you all.

We will now start our questioning. We will do two rounds of questions and will start the first round with Mr. Jeneroux.

Please go ahead, Mr. Jeneroux, for six minutes.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Thank you, Mr. Chair, and thank you to all the witnesses for taking the time out of the summer to be here with us.

Dr. Halperin, I have a quick comment to your comments. Coordination and logistics are certainly things we've heard about across the board in the response to this pandemic. Any specific examples that you can provide in that regard would certainly be helpful, as of course we're looking to make sure that the government's response to other potential pandemics is better the next time around.

Dr. Neame, I would like to start with you. With regard to some of the comments you made about the vaccine and vaccine research, we're hearing daily that new research dollars are being put here and new research dollars are being put there, not just in Canada but across the world. How likely is Canada to receive this vaccine, given competition from other countries such as the U.S. and China?

[Dr. Dion Neame]

Many of the IMC companies are, in fact, global companies. We will be working to develop vaccines, and when we develop those vaccines, it will be based on many of the volumes that we will...to understand the distribution.

I think one of the most important things is that it may necessarily not be—

[The Chair, Liberal, Ron McKinnon]

Pardon me, Mr. Neame, but could you hold up your mike, please?

[Dr. Dion Neame]

Yes. Thank you.

Part of what's going to be happening is the distribution of the vaccines. We have global organizations, in which Canada is involved, to understand how we will be distributing those vaccines. That also depends on, specifically, which company would produce the vaccine. I can direct you to Dr. Halperin, who is doing a lot of work on research for vaccines that are going to be in clinical trials here in Canada. He may be able to comment on that.

I can say that—

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Sorry, Dr. Neame, but I'm short on time. Is it your opinion that Canada is at the table right now in terms of being able to get a vaccine, while in competition with other countries like the U.S. and China that are pouring lots of money into this?

[Dr. Dion Neame]

Yes, I would say that, and I would actually direct you to Dr. Halperin at this point.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Sure, I'd love to talk to Dr. Halperin about that, but I also want to talk to Ms. Fralick in regard to some of the PMPRB comments, as well. It's a major hurdle in getting a lot of these drugs to market.

Recently I read a few pieces that you produced, Pam. Would you say that here in Canada pre-COVID-19 to post-COVID-19 there has been a drastic increase in the competition for global investment dollars?

[Pamela Fralick]

I don't have data to speak specifically to that demarcation.

I can certainly say that in the pharmaceutical world and in life sciences, we have been struggling to attract global investment to Canada over the last couple of years, and that continues, but that is related to the uncertainty and now, frankly, the devastating implications of the Patented Medicine Prices Review Board changes that have been made, the regulatory changes.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

I will just highlight some of your comments. I believe it was in The Globe and Mail that you said the following:

Companies are not going to bring their latest, greatest, newest innovative drugs into a clinical trial in Canada if they have a good sense that that drug is not going to be available in Canada after the trial.... This means the patients, you and I, our families, friends and colleagues, are not necessarily going to have the drugs we need and should have.

That was on June 18. Has anything changed, in your opinion, since then?

[Pamela Fralick]

No, in our opinion, it hasn't. Our concerns remain the same. Our biggest driver in this industry is making sure that Canadians, patients, have access to the medicines they need. It sounds like a cliché, but there is no business without that outcome.

What we are seeing is, again, the uncertainty and the lack of balance between cost-containment initiatives and a drive for investment in this country, which is affecting the global desire to invest in this country. The companies are very aware of sustainability issues in health systems, but they need a viable business model to bring their products into this country. They're quite, and increasingly, reluctant to bring new, innovative products for clinical trials, as an example. We've seen a reduction of up to 50% in clinical trials since the regulations were brought in. Ethically, they understand that these drugs may not be available to those Canadians, given the regulations that will, at this point in time, come into play on the first of January.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Ultimately, it's the patients who will suffer, in your opinion.

[Pamela Fralick]

It's all about the patients. As you say, there is no industry without patients, and there is no industry without good outcomes for these patients. That is the driver, yes.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

We heard that recently the PMPRB changes have now been pushed back to January. Have you had any sense that this is going to make a difference in terms of...? I believe one of your comments was that “Fortunately, it is not too late to find a solution that will avert this outcome. Industry is prepared to come forward.... We hope that government will be a willing partner.”

Have you had any sense that things are going to change?

[Pamela Fralick]

I remain an eternal optimist. I would like to think that this slight delay will give us the opportunity to open that door.

The industry has, for the last two years, been very open to working with government to find the best policy solutions possible. We have brought ideas and efforts forward. We are a global industry. We have many examples of where there is a very strong and collaborative relationship between industry, patients and governments. We've drawn from those to produce some ideas that we think government should be considering. We are entering into further discussions over the summer to do exactly that, and we will be pushing hard for a door to be opened. Let's get the best solution for Canadians, not just the one that is perhaps expedient.

[The Chair, Liberal, Ron McKinnon]

Mr. Kelloway, you have six minutes.