Health Committee on May 23rd, 2024

[Michelle Boudreau]

Yes.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Thank you.

This organization carries out negotiations, regarding medication in particular, to obtain the best prices through a bulk purchasing process. Is that correct?

[Michelle Boudreau]

Yes.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Under the current pharmacare framework—

[The Chair, Liberal, Sean Casey]

Sorry to interrupt you, Mr. Blanchette‑Joncas, but you're out of time. Two and a half minutes go by quickly.

Mr. Julian, you have the floor, also for two and a half minutes.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Thank you.

I'd just like to make sure that you received the statement issued a few hours ago by nine Quebec labour and community groups calling for the adoption of Bill C‑64. Did you receive it? If not, I can provide it to you. The Union des consommateurs, the Centrale des syndicats démocratiques and the Confédération des syndicats nationaux, to name a few, were very clear. There's a consensus in Quebec in favour of the bill.

I come back to the issue of the approval process of Health Canada. I think my Conservative colleague cut you off, but it's important for members of the committee to understand. Is it a 300-day period for approval, through Health Canada, from the application date to availability for consumers? I just want to understand what you were saying.

[Michelle Boudreau]

I'm going to ask my colleague to fill in a little, but just to be clear, yes, what I was referring to is the period during which Health Canada will review a drug for authorization in Canada and when it will conclude that review.

Then what I was trying to refer to as well is that there are other processes that typically take place before a product will be available at, say, a pharmacy. That includes a review, which we call the health technology assessment, by CADTH—or INESSS in Quebec—and then there will be perhaps some negotiation on pricing.

However, my colleague can fill in those other steps as well, if the chair permits.

[Daniel MacDonald]

In terms of the data that Michelle was referring to, it's the Health Canada regulatory standard of 300 calendar days service, and that is met over 99% of the time. As Michelle mentioned, there are expedited routes in there as well.

Further on the detail of the rest of the drug approval process, there is the health technology assessment approval process. I will be referring to the report by the Conference Board of Canada, “Access and Time to Patient”. That's the data I'll be referencing. It's a January 2024 product. It identifies that the time to review a product following a notice of compliance from Health Canada through the former CADTH is 246 days. That's 2022 data. The average time spent for products that were waiting to be engaged by the pCPA after—this is CADTH data only, as I don't have it for the INESSS—was 172 days in 2022, with an average time spent in the pCPA negotiations of 189 days.

There are different sources on what that total time is. You've referenced a data point that, as we said, we don't have in front of us. We have from 736 to, as another data source I have suggests, 900, but each of those steps is performing a function and....

I'm sorry.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. MacDonald.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Just as a quick follow-up, what was the shortest expedited approval?

[The Chair, Liberal, Sean Casey]

No, no. We're well past the time, Mr. Julian.

[Daniel MacDonald]

It was 180 days.

[The Chair, Liberal, Sean Casey]

Ms. Goodridge, you have five minutes, please.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

I have a point of order, Chair.

[The Chair, Liberal, Sean Casey]

Go ahead, Mr. Ellis.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

I guess the question is whether we are going to enforce this. I mean, you told Mr. Julian to stop talking. He still asked the question. He still received an answer.

Do you know what? I guess if we have rules here, Chair, I would expect that we follow them. If we're not going to follow them, then we'll have utter chaos, which we had with Mr. Julian at the last committee meeting when he chose to simply ignore the rules of the chair.

I would implore the chair to enforce those rules. I would also implore my colleague Mr. Julian, who is wont to not follow the rules, to actually follow them and be respectful to the committee.

[The Chair, Liberal, Sean Casey]

Go ahead, Mr. Julian.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

On a point of order, Mr. Chair, at the last meeting, of course, the chair made a mistake. I challenged that, which is absolutely appropriate. However, in this case, when an answer is something that all members of the committee want to hear, I think it's to the advantage of all members of the committee to actually get that answer.

[An hon. member]

We didn't hear the question, and nor did we hear the answer.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

It was 180 days.

[The Chair, Liberal, Sean Casey]

Let's try to get through the last couple of rounds of questions. Mr. Julian's turn is done and Ms. Goodridge's turn is about to begin.

Go ahead, Ms. Goodridge, please.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you, Mr. Chair.

I always find it very very interesting to listen to the questions that come from Dr. Powlowski. His experience when it comes to medicine is something that I truly do appreciate. Understanding the law background further makes it so that I don't feel nearly as stupid, because I also had some of those same exact concerns when it came to reading this bill. I just figured that maybe it was that I didn't necessarily understand it.

We have a very limited number of definitions in this bill, and yet we are using terms that are relatively new. Why did Health Canada choose not to define “first dollar” or “single payer” in this piece of legislation?

[Michelle Boudreau]

I'll speak first to “single payer”. It's a term that is used very commonly. It was used as far back as the 2019 panel report by Dr. Hoskins and that advisory panel. It's quite a well-understood term. For that reason, there was, in our view, no need to define it.

Similarly, “first dollar”, as I mentioned, does have a definition that's quite well understood. It's not unusual in legislation that if there is a technical term that's understood within a context, you don't define it, because it has a meaning already.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

I appreciate that. So “minister” is not a defined term that is understood...?

[Michelle Boudreau]

That's more of a custom. Whoever the minister is that has oversight over legislation would typically be set out in the legislation.