Health Committee on May 2nd, 2023

[Prof. Matthew Herder]

I don't recall that specific statement.

[Don Davies, NDP, Vancouver Kingsway, BC]

She says, in her letter elucidating on her resignation, that PMPRB staff failed to follow up on her request to meet with the Minister of Health, despite her insistence. Is that correct?

[Douglas Clark]

I think what she means is that we failed to obtain a meeting for her.

[Don Davies, NDP, Vancouver Kingsway, BC]

To your knowledge, did she attempt to get a meeting with the minister to discuss his guidelines?

[Douglas Clark]

She directed me and one of my staff on multiple occasions to do that. We sought to operationalize that. She also, in her letter of reply to the minister, asked for a meeting.

[Don Davies, NDP, Vancouver Kingsway, BC]

In the minister's letter of November 28, he requested that the PMPRB suspend the consultations, not extend them. What's the difference between these two? Why would he suspend the consultations instead of extending them if he wanted time to be consulted?

[Douglas Clark]

That is a question that baffles me to this day.

First of all, we have a duty to consult the minister on our guidelines, not on our consultation process. If the concern is that stakeholders haven't had enough time to properly understand the mechanisms that are being consulted on—it would be out of order to make any kind of request in relation to the process—you would think that if you were going to ask for anything, it would be for an extension.

Professor Herder already spoke about this. At the end of the day, once the board had gotten all of the feedback from stakeholders, I think it was more likely than not that given the tenor of the feedback from industry, we would have extended or even put forward a second round of—

[Adam van Koeverden, Liberal, Milton, ON]

Mr. Chair, I have a point of order. I'd like to point out a misquote.

I believe that Mr. Davies is unintentionally misquoting the minister with respect to inviting the board “to consider pausing the consultation process [so as] to allow more time” to work collaboratively with all stakeholders to “understand fully the short- and long-term impacts of the proposed new guidelines.” That's being taken well out of context in the line of questioning.

[The Chair, Liberal, Sean Casey]

Keep in mind that this is not a point of order. It is something that you will have the opportunity to clarify when you have the floor.

Mr. Davies, you still have a minute.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

During the 60-day consultation period, the minister and his staff met with the pharmaceutical industry 15 times. That's just in that consultation period alone. With the PMPRB, which is apparently legally obligated by the Patent Act to consult, it was zero times.

What is your reaction to that?

[Douglas Clark]

Well, I think, as everybody here knows, the government is quite intent on attracting investment in domestic manufacturing capacity in the event of a future pandemic. I think it's also pretty clear that the PMPRB reforms are the fly in the ointment in those efforts. I think the imperative of smoothing out relations with the industry trumped any consideration of whether the guidelines were sound policy or had merit.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Herder, do you have a take on that?

[Prof. Matthew Herder]

Only to echo the same. It was a choice.

It in some ways suggests to me that perhaps the minister was more informed about what industry's concerns actually were than we were. We were told by industry that they wanted us to suspend, but outlining in detail what their concerns with the proposed guidelines actually were didn't happen until the very end of the consultation process.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Davies and Mr. Herder.

Next is Mr. Jeneroux, please, for five minutes.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Thank you, Mr. Chair.

Thanks to the witnesses for being here today.

This isn't really a good look for the PMPRB in general. I imagine both of you probably joined the PMPRB—you, Mr. Clark, through the executive director role and you, Mr. Herder, through the board role—in a way, to make drug pricing better in this country. It's obviously spiralled to this point where you're here testifying before a health committee, as some of your former colleagues have.

Mr. Clark, you've been there at the PMPRB for quite a while. Where did this all start going down this path? Where did this begin that led you here today?

[Douglas Clark]

That's a really good question.

Look, the government adopted a regulatory policy that its own analysts said was going to result in $10 billion less revenue for the industry. They turned it over to us to operationalize that policy, but I think with an expectation that we were all going to have a good time and get along. That was just not possible.

The PMPRB is the David to the Goliath of a transnational trillion-dollar industry. Our annual budget is a fraction of what many multinational pharmaceutical CEOs make in executive compensation. If the expectation is that we are required to operationalize a policy that will remove $10 billion or $3 billion out of industry coffers in a way that has the blessing of that industry, it's a recipe for futility.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Would you agree, Mr. Herder?

[Prof. Matthew Herder]

Yes.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Going back to the earlier questioning about what did or didn't happen with the minister getting an invitation or not to meet with the PMPRB, to summarize, the executive director of the PMPRB reached out—at your count, in five attempts—to meet with the minister. The minister was careful in his wording last week when he said, “I never received an invitation from the chair of the board.”

In the past, you said that you've met with ministers Hajdu, Petitpas Taylor and Ambrose. Was it the same approach taken by you to get there, Mr. Clark?

I'll put a second question on that. When you didn't get a positive response to meet with the minister, did you perhaps reach out to the parliamentary secretary of health to provide a briefing instead?

[Douglas Clark]

The process has always varied in the past, depending on the circumstances. Sometimes I would reach out to the chief of staff or the senior policy adviser and say that this issue is on the radar and we should probably discuss it.

I would say that more often then not, it was reversed. I would get a call from the minister's office wanting to discuss something, and then we would have to make a decision as to whether this warranted elevating it to the minister and briefing the minister.

Typically, more formally, when ministerial briefings were arranged that I attended and briefed the minister on, that request came from the minister's office via the deputy minister's office and came over to our group. Under the act, section 102 of the Patent Act—I think Mr. Davies raised this point on Thursday—the minister has the authority to convene the chair. No corresponding authority resides in the chairperson. It has almost always come from the other direction, so I don't understand that.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

You said that you got a response that I guess was basically a non-response from the minister's chief of staff.

Did you get a response, then, from the deputy minister on why the minister wasn't planning to meet with you or didn't end up meeting with you?

[Douglas Clark]

No.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

You said no. Okay.

The briefings weren't available, obviously, through this major reform that was about to happen. Is that part of—I guess to my initial question—what leads you here today? That didn't help the situation in terms of getting the PMPRB together as a cohesive group, and now we're seeing mass resignations from the board.

[Douglas Clark]

Yes, for sure. That's where things started to basically unravel.

When you're meeting 13 times with the industry and zero times with an agency within your own portfolio, I don't think good things can come from that generally. That doesn't include the meetings that were also held between industry and Health Canada officials at the bureaucratic level.

Again, we met with our counterparts at Health seven times over the course of those consultations. At no time were we told that that there was any concern about either the substance of the guidelines or the process surrounding them.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Clark.

We're going to go now to Ms. Sidhu, please, for five minutes.