Health Committee on Dec. 11th, 2020

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

Madam Beauchemin, if I understood your testimony correctly, you acknowledge that the pharmaceutical industry provides rebates to provinces. We heard testimony from the PMPRB officials a few weeks ago that part of the changes will require transparency, so that they have a better understanding of what the real prices are in the marketplace to help them set effective pricing for Canadians.

Do you oppose that requirement to have pharmaceutical companies transparently reveal the rebates that they're giving?

[Annie Beauchemin]

Let me take you through the process—

[Don Davies, NDP, Vancouver Kingsway, BC]

No, I don't want you to take me through the process. I just want to know if you oppose the requirement for transparency or not.

[Annie Beauchemin]

This will get to what you're referring to.

I think it's really important to understand that the original intent of the PMPRB was to prevent abuse of excessive prices, and what's happening here goes well beyond this. Our concern is that the guidelines create a great deal of uncertainty, which will prevent life-saving medications from coming to Canada. It is in the jurisdiction of the provinces to negotiate prices. The way the process works now, the pCPA, which is an alliance of provinces, negotiates with companies like ours based on the value that's assigned to a drug, based on an assessment of experts, and then—

[Don Davies, NDP, Vancouver Kingsway, BC]

I'm sorry, Ms. Beauchemin. I have limited time. I'm sorry. I'm not going to let you take time to explain things. I want an answer to the question. I understand there are rebates given by pharmaceutical companies.

[Annie Beauchemin]

Yes, and they are significant.

[Don Davies, NDP, Vancouver Kingsway, BC]

They don't seem to want to reveal those to the PMPRB, which results in a skewed idea from the PMPRB about what the real prices are. Do you or do you not support transparency in the rebates?

[Annie Beauchemin]

Those rebates are confidential based on negotiations with the province.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you. I understand.

Mr. Alibhai, you made a claim that you thought the PMPRB changes would reduce clinical trials in Canada. What evidence or data do you have to support that, and would you provide that to the committee?

I'm sorry, Mr. Chair. Could you please stop the clock? I don't know where Mr. Alibhai is.

[Mehmood Alibhai]

I'm sorry. I was muted.

[The Chair, Liberal, Ron McKinnon]

I have stopped the clock. I'll restart it in a couple of seconds. Thank you.

Go ahead, Mr. Alibhai.

[Mehmood Alibhai]

Thank you for the question, honourable member.

All you have to do is take a look at what's transpired since 2018 when the PMPRB guidelines were initially put out, from the perspective of clinical trials and from the perspective of new drug launches in Canada. Of 34 drug launches globally, 21 of those drugs have not been launched in Canada. These drugs represent rare disease oncology products. Beyond that, honourable member, if you take a look at the clinicaltrials.gov website, where all clinical trials have to register—it's a federal website—the number of clinical trials in Canada has dropped significantly since these guidelines were put out. All you need to do is take a look at what's transpired since 2018, and the data is there.

[Don Davies, NDP, Vancouver Kingsway, BC]

Obviously the PMPRB changes are not in force, so you're saying that the mere possibility of PMPRB changes has caused pharmaceutical companies to decide on their own not to launch clinical trials in Canada. Is that what you're saying?

[Mehmood Alibhai]

The pharmaceutical industry plans long term—three to five years—in the clinical trials that we establish in any jurisdiction, in the kind of health system partnerships we establish in Canada, and in patient support programs to take care of patients who may fall between the gaps. The guidelines have resulted in significant unpredictability and significant uncertainty. It—

[Don Davies, NDP, Vancouver Kingsway, BC]

Can I jump in and suggest, Mr. Alibhai, that it's going to result in reduced profits for the pharmaceutical company? Would you agree with that?

[Mehmood Alibhai]

I would say that, if you take a look at the submissions that the patient organizations have made—

[Don Davies, NDP, Vancouver Kingsway, BC]

No, I'm asking about the pharmaceutical companies. Is it their concern, sir, that they're going to have reduced pharmaceutical profits if the PMPRB changes come into effect? Is that a fact or not?

[Mehmood Alibhai]

Thank you for asking—

[Annie Beauchemin]

Our concern is that we will not be able to bring life-saving drugs to Canadian patients.

[Don Davies, NDP, Vancouver Kingsway, BC]

Profits have nothing to do with the issue. Is that what you're saying?

[Mehmood Alibhai]

No. If I could share with you, Mr. Davies—

[Don Davies, NDP, Vancouver Kingsway, BC]

Okay. I think there was a letter that was recently sent by the pharmaceutical industry to the Canadian government that offered to pay a billion dollars to the federal government if they did not proceed with the PMPRB changes. I think they estimated that they would lose $10 billion over the next 10 years.

I'm going to turn my next question to Mr. Frank.

Mr. Frank, you correctly pointed out that the PMPRB changes would result in reduced costs to employers in this country. Do you have any idea of the estimated cost savings to employers in this country from the PMPRB changes?

[Stephen Frank]

We have to base our estimates off what the PMPRB's estimates are. The savings to employers would be somewhere around 10% of what's spent currently, which is a significant amount of money. It would be in the billions of dollars, over time, that we would expect to be passed through to employers, and that would, like I said in my notes, allow the capacity and the room for them to contemplate providing funding for these new medications. The envelope is getting full, and the idea that there's even the capacity to pay for some of these new medications, if we don't make some room on what we're already covering, I don't think is correct. We need to address the prices in order for us to be able to even contemplate some of these new therapies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

[The Chair, Liberal, Ron McKinnon]

That ends our first round.

We'll start our second round with Mr. d'Entremont once again.

Mr. d'Entremont, please go ahead for five minutes.