Health Committee on March 11th, 2020

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

You're right...and I didn't even notice.

[Voices]

Oh, oh!

[Luc Thériault, Bloc, Montcalm, QC]

I have a question for Dr. Mithani.

Guy Saint-Jacques, Canada's former ambassador to China, said this week that he was concerned that the Canadian government wasn't adequately inspecting products imported from China, even though 23% of farmland in China is allegedly contaminated with heavy metals.

China has implemented, and is implementing, retaliatory measures against some of our products. Mr. Saint-Jacques said that Canada should respond by conducting more rigorous inspections of Chinese products that enter the country. The farming community often considers reciprocity of standards.

Mr. Saint-Jacques believes that Canada has been too timid and that there could be more benefits if the health and safety of Canadians were better ensured through inspections. In his opinion, China should be told, “If you want to play hardball, it's a two-player game.”

Do you recommend this tough approach? How could you prioritize the agency's resources to ensure that you have staff to monitor both the borders and the products in supermarkets?

[Dr. Siddika Mithani, President, Canadian Food Inspection Agency]

Thank you for the question.

You must know that our agency enforces the regulations.

From our perspective in terms of the agency, it is about the science-based, regulatory decisions that we make. When we look at agriculture and when we look at market access for products, to China or to any other country, those are really based on the requirements that we would want for our domestic products as well as exports and for our imports. There are no differences in terms of what we expect with respect to our agricultural products coming in or going out.

I would say that from a regulatory perspective, the focus is really on having science-based requirements, whether you're looking at domestic or imports.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Mithani.

Thank you, Mr. Thériault.

[Luc Thériault, Bloc, Montcalm, QC]

Is my time already up?

[The Chair, Liberal, Ron McKinnon]

Yes.

[Luc Thériault, Bloc, Montcalm, QC]

You weren't very generous.

[The Chair, Liberal, Ron McKinnon]

Mr. Davies, go ahead for two and half minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

I've had the privilege of being the health critic for the New Democrats since 2015. I remember this vividly, but I went and pulled it anyway. It's the mandate letter that Prime Minister Trudeau gave to Health Minister Jane Philpott. It says, from 2015, “I will expect you to work with your colleagues...to deliver on your top priorities:...improve access to necessary prescription medicines. This will include...reducing the cost Canadian governments pay for these drugs, making them more affordable for Canadians”.

Anecdotally, it's been my experience that there's been no appreciable increase in access to prescriptions nor have prices come down, but I didn't rely on that. I went to CIHI and I asked them about a month ago to tell me what happened with drug prices in Canada from 2015 to 2019. What I found was that they've gone up every single year, both in a global way and on a per capita basis. In fact, drugs were 8.6% more expensive in 2019 than they were in 2015.

What's puzzling to me is that in 2016 the Liberal government first announced its intention to reform Canada's patented medicines regulations in order to lower the price of prescription drugs for Canadians. We know that your government estimated this would lower drug prices by $13 billion over 10 years, and your government announced that they were meant to come into force by January 1, 2019. That still hasn't happened.

Minister, given that prescription drug costs have gone up every single year since the Liberals took office in 2015, why is your government delaying these necessary reforms?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Far from delaying the necessary reforms, we're taking the necessary steps to lay down the track for a national pharmacare program. As you know, this is not easy work nor is it fast work. It's work that has to be done in partnership with provinces and territories and those conversations have been ongoing. As you know, in budget 2019 we took important next steps in terms of committing to the Canadian drug agency, ensuring that we could work on a formulary together, and that work is ongoing.

I will also say that PRB regulations were released in the summer of 2019. Those will mean $13.2 billion in savings, and we're working on the guidelines now. They will come into force in July 2020. I think it's important that we understand that this is a longer-term project.

[Don Davies, NDP, Vancouver Kingsway, BC]

That's good if they come into force in 2020. That's what I needed to know, when they're coming in.

I have very little time, Minister, so I want to quickly move to vaping. We know tens of thousands of young Canadians are becoming addicted to nicotine at an alarming rate from vaping products. Recent data revealed a 74% spike in youth vaping in Canada over a single year, and we know why. Big tobacco companies are using attractive flavours, high nicotine content and aggressive advertising to hook a new generation of Canadians on this highly addictive product. When are you going to act to ban flavours, reduce high nicotine content and restrict advertising of these products? If you are going to do that, when can we see those?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

First, as you know, on December 19, 2019, we proposed new regulations to prohibit the promotion and advertising of vaping products to youth anywhere they can be seen or heard. Those proposed regulations were published in the Canada Gazette, part 1, on December 21 for a public commentary of 30 days. The department is reviewing the feedback right now, and we'll be moving to finalize the regulations as soon as possible.

Building on the feedback that we heard through consultations we held in 2019, we also know we need to develop additional regulations that further reduce the appeal. Also, nicotine concentration and flavours are two of the areas where we believe we need to take stronger and quicker action. Those are two areas of deep concern for me as well.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Davies.

We have 10 minutes left. We don't really have time for a full round again. I'm going to suggest to the committee that each party take two and a half minutes and we go around once more. Is that okay?

[Some hon. members]

Agreed.

[The Chair, Liberal, Ron McKinnon]

With that, we'll go now to Mr. Jeneroux.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Thank you, Mr. Chair.

Since October 2019, 25 new medicines have been launched in the United States and none of them have been submitted to Health Canada. The PMPRB regulatory changes require reductions of up to 90% for some new therapies, especially for rare disorders. There is some concern that these changes are keeping innovative drugs from applying here in Canada. I have two questions for you, Minister. Why are you rushing to implement these regulations, which seem to be blocking new life-saving medicines from coming to Canada, and can you tell Canadians with 100% confidence that these regulatory changes will not affect Canada's drug supply?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Of course, having access to medication that people need is of utmost importance to us all, especially new medications that many of us hear about, sometimes for the first time, through constituents who may have rare diseases.

We're working with the pharmaceutical agencies on guidelines. We're engaging with them. We're receiving their feedback, and we're benchmarking with other countries.

It's important that we get the balance right and that we work with drug companies, but also that we have a focus on keeping medication affordable in Canada. We'll continue to do that work.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Are you open to changing the date? July 1 is the proposed date. Are you open to altering that and hearing, perhaps, from more patients who would like to give their feedback on this?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

I'll let my deputy answer. He has some details on this.

[Dr. Stephen Lucas]

The Patented Medicine Prices Review Board launched consultations on the guidelines in the late fall. They did extend the period until mid-February. They are working with that feedback and have been engaging with industry, patient groups and others to ensure the guidelines reflect the regulations, the government's intent, and the concerns and interests of different stakeholder groups, including industry.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Would you be open to delaying the implementation, though, and continuing to hear from more patients? I've certainly heard that not a lot of patients have been heard from.

[Dr. Stephen Lucas]

The Patented Medicine Prices Review Board is reviewing the input they've received and are committed to continuing to engage to ensure the guidelines can move forward to enable the regulations to come in.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

It's a hard July.

[Dr. Stephen Lucas]

That is the coming into force the government had set, and the engagement process on the regulations has been open and transparent and will continue with the feedback received.