Health Committee on April 27th, 2023

[The Chair, Liberal, Sean Casey]

I call this meeting to order.

Welcome to meeting number 64 of the House of Commons Standing Committee on Health.

Today we will meet for two hours to begin our study of the Patented Medicine Prices Review Board.

Today's meeting is taking place in a hybrid format pursuant to the House order of June 23, 2022, in accordance with our routine motion.

I'm informing the committee that all participants in the meeting have completed the required connection tests in advance of the meeting.

I will also take this opportunity to give this reminder—although I don't think this panel of witnesses needs it—that the convention we follow in this committee is that the length of an answer shouldn't substantially exceed the length of time to pose the question. If you're embarking on a long answer, you can expect to be interrupted, either by the person who posed the question or by me. If you seek to interrupt before the witness has had a full opportunity to respond with a response of equal length, you can expect that I will intervene to allow them to continue.

With that, please allow me to welcome the Honourable Jean-Yves Duclos, Minister of Health, who is joining us for the first hour.

He's joined by the following officials from the department of Health: Dr. Stephen Lucas, deputy minister, and Eric Bélair, associate assistant deputy minister from the strategic policy branch.

From the Department of Justice, we have Nessim Abu-Zahra, counsel, health legal services unit.

It's always nice to see you, Minister. Welcome to the committee. We will begin with opening remarks from you for up to five minutes. You have the floor.

[Jean-Yves Duclos, Liberal, Minister of Health]

Thank you. Mr. Chair.

I'd like to thank the committee for this opportunity to speak about what the government is doing to improve Canadians’ access to quality and affordable medicines.

With me today from the Department of Health are Mr. Stephen Lucas, Deputy Minister, Mr. Eric Bélair, Associate Assistant Deputy Minister, Strategic Policy Branch, as well as Mr. Nessim Abu-Zahra, counsel, from the Department of Justice Health Legal Services Unit.

Canada has among the highest patented medicine prices in the world, and these high prices can impact the ability of patients to access new medicines. This is unacceptable.

The Government of Canada supports and respects the role of the Patented Medicine Prices Review Board, the PMPRB, as a strong, independent quasi-judicial body that protects the interests of Canadian consumers by ensuring that the prices of patented medicines sold in Canada are not excessive.

Today, I will begin my remarks with a few words about my role with respect to the PMPRB, the role of PMPRB itself, as well as the role of Health Canada.

The PMPRB is an independent, quasi-judicial body that carries out its mandate at arm's length from the Minister of Health and operates independently from Health Canada.

As Minister of Health, I am responsible for the patented medicine pricing provisions of the Patent Act. These sections of the act establish the PMPRB and its authorities, as well as my responsibilities with respect to the board.

The patented medicines regulations fall under my responsibility as Minister of Health. In fact, the Patent Act sets out that certain regulations can be made by only the Governor in Council, based on my recommendation, following consultation with stakeholders, including provinces and territories, consumer groups and the pharmaceutical industry.

It is also subsection 96(4) of the Patent Act that gives PMPRB, after consultation, the authority to issue non-binding guidelines.

You will recall that following the initial publication in 2019 of the proposed amendments to the patented medicines regulations, the validity of the amendments was challenged in the Federal Court and the Quebec Superior Court. Although aspects of the amendments were held to be valid, important elements were struck down. In particular, the Quebec Court of Appeal found that two elements were unconstitutional.

On July 1, 2022, revised amendments to the patented medicines regulations came into force to provide the PMPRB with new tools to protect Canadians from excessive prices. To operationalize these amendments to the patented medicines regulations and to modernize other aspects of its existing guidelines, the PMPRB proposed new guidelines in October 2022 and posted them for a 60-day consultation period.

Subsection 96(5) of the Patent Act states that the PMPRB must consult with various parties, including the Minister of Health, before the issuance of any guidelines. This requirement to consult and who must be consulted were also highlighted in the letter published on March 3, 2023, by the former acting chairperson.

It is in that context that I provided a letter to the chairperson of the PMPRB, sharing my views with respect to the consultations on the proposed guidelines. In this letter, I respectfully invited the board to consider pausing the consultation process to allow more time for stakeholders, including provinces and territories, to fully understand the short- and long-term impacts of the proposed new guidelines.

In the interests of transparency, this letter has also been made public.

In my role as Minister of Health, I meet regularly with a wide range of stakeholders on many issues that touch the health of Canadians. That's also what I'm doing here. I've heard the views of industry. I've also listened to the concerns of patients, health care professionals and other stakeholders, including my counterparts across the country, about access to medicines.

It is with this in mind, in view of the importance of this issue, that I asked that the PMPRB consider a pause as a way to allow all stakeholders to engage meaningfully in the consultation process.

Our government has undertaken an ambitious pharmaceutical, biomanufacturing and life sciences agenda. That includes moving ahead with the regulatory amendments to the patented medicines regulations, improving access to medications, accelerating innovation and streamlining regulations and having a national strategy for drugs for rare diseases, all while supporting a vibrant biomanufacturing and life sciences industry.

We are also making progress towards establishing a Canadian drug agency, and we remain committed to tabling a pharmacare act.

To conclude, I want to underscore the fact that our government is firmly determined to improve accessibility to medicines at more affordable prices. The PMPRB will continue to play an important role in exercising its authority as an independent body to oversee the prices of patented medicines in Canada.

I'd be happy to answer your questions.

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

We're going to begin the round of questions with the Conservatives.

Dr. Ellis, you have the floor for six minutes.

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

Thank you very much, Chair.

Thank you, as always, Minister, for being here.

I have a question for you. Prior to November of 2022, was the PMPRB doing their job?

[Jean-Yves Duclos, Liberal, Québec, QC]

Prior to which time...?

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

November 2022.

[Jean-Yves Duclos, Liberal, Québec, QC]

I understand.

Yes.

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

You think they're doing their job, but Canadians pay the highest prices for drugs, as you said in your opening remarks, the highest prices for medicines in almost the entire world.

[Jean-Yves Duclos, Liberal, Québec, QC]

I think it's important to remind everyone and every Canadian of that. It is unacceptable that compared to all comparable countries, we are paying much more. The only two countries in the world where patented drug prices are higher are the United States and Switzerland.

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

Right, and you told us in your opening remarks that the mandate of the PMPRB is really quite simply to understand that patented drug prices need to be under control. That was the original mandate of the PMPRB, was it not?

[Jean-Yves Duclos, Liberal, Québec, QC]

The mandate of the PMPRB is twofold: first is a regulatory role, and then there is a reporting role. From a regulatory perspective, it is one of the many other tools and policies that are being used by the Government of Canada to bring down the cost of drugs and to increase accessibility. From an informational reporting perspective, the PMPRB also informs Canadians as to the types of prices we are facing in Canada.

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

Right, so again, prices we've heard twice, and we have the third-highest prices in the world, but you still want to say they were doing their job. I guess my question is, what took you so long to intervene?

[Jean-Yves Duclos, Liberal, Québec, QC]

That's exactly why we have a broad range of policies and tools, and they are starting to make an important impact on the affordability, the quality, the appropriateness and the accessibility of drugs in Canada. This is an important part of our broader agenda, part of which is indeed around the responsibility of the new regulations introduced early in July 2022 to keep bringing these prices down.

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

Great. Thank you for that.

Minister, to change gears a bit, can you tell Canadians how many times you met with drug manufacturers and drug companies—people who in the vernacular we might call “lobbyists”—in the last year?

[Jean-Yves Duclos, Liberal, Québec, QC]

I keep meeting lots of people who are both interested in and sometimes have an important responsibility in increasing accessibility and affordability of drugs in Canada. That includes obviously my colleagues, the health ministers across Canada, who have a very hard job to do. That also includes patient groups, researchers, scientists—

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

Minister, I'm going to use the interrupter clause the chair spoke to earlier.

How many times in the last year, sir, did you meet with folks whom we would consider lobbyists from the drug manufacturing sector ?

[Jean-Yves Duclos, Liberal, Québec, QC]

I have met those members of the industry, including exporters, manufacturers and developers, for all sorts of reasons, including addressing the analgesics shortages that we saw.

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

Excuse me, sir. Is it fair to say that it would be 20 times, 50 times or 100 times? Do you have any idea?

[Jean-Yves Duclos, Liberal, Québec, QC]

I have meetings with stakeholders. I'm having them today. Typically they come in groups. I would meet the patient groups, the researchers and the manufacturers together, so that we work together and exchange the same information on how we move forward on increasing access and affordability in a world in which we know access to drugs will be key to cure all sorts of diseases that are emerging, and for which we have—

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

Great. I'll interrupt again through you, Chair, if you don't mind, Minister.

I agree with you. Those are great and lovely things that we want to happen here in Canada. Quite sadly, though, they're not happening. Can you tell me, sir, how many manufacturing sites we have for influenza vaccines in Canada at the current time?

[Jean-Yves Duclos, Liberal, Québec, QC]

Well, there is one in my own region. GSK has received a contract to produce influenza vaccines for the next years. We are investing with Sanofi in Ontario, in Toronto, in constructing a new influenza vaccine production facility. We are investing in many other parts of Canada. We have strong—

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

Thank you, sir, and again, through you, Chair, I'll interrupt you: Are they actually manufacturing vaccines in those facilities in Canada?

[Jean-Yves Duclos, Liberal, Québec, QC]

I believe they do, and they will be increasingly doing so, because this is part of the strong $2.2-billion biomanufacturing—

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

Great, sir, and I'm going to interrupt you again, through you, Chair.

Mr. Lucas, how many manufacturing facilities are actually making influenza vaccine in Canada?

[Dr. Stephen Lucas, Deputy Minister, Department of Health]

Mr. Chair, as the minister noted, the government has a contract with GSK. The investment for Sanofi is for a new site in Ontario.