Health Committee on May 2nd, 2023

[Don Davies, NDP, Vancouver Kingsway, BC]

No, I meant the consultations with the PMPRB.

[Douglas Clark]

Oh, I'm sorry. I thought you said....

I'm not aware of him having met at all with his counterparts in other provinces. We briefed provincial ministries on our guidelines, and I'm not aware of his having met with the board since that letter.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Clark.

Mr. Aboultaif, you have five minutes.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Thank you.

Thanks to both of you for appearing today.

Dr. Herder, you joined the PMPRB to make changes to policies to positively affect the bottom line of getting the best value for the dollar. How many policy changes were you able to achieve in being there since June 2018?

[Prof. Matthew Herder]

Effectively, we were not able to achieve any changes in that time frame. Obviously, the pandemic was a major factor in all of that. We worked quite hard to try to change guidelines as the court cases were proceeding and as we waited for the regulations to be declared into force. We did a lot of consultation and policy development, but none of those things have translated into actual policy changes to date.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

When you were hired to do the job, how many interviews did you have with the department before you got the job?

[Prof. Matthew Herder]

There were at least two interviews and also a written exam, which I was quite nervous about. I teach patent law, so in being examined on it for the first time in a long time, I was worried that I wouldn't do so well, but obviously I did okay.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

I'm sure that you probably asked about the process and how the communication was going to be between you and what you do with the department. All this clear communication or road map was clear to you before you joined. Have you seen any difference after you joined? Were you surprised about how this communication is taking place?

[Prof. Matthew Herder]

What happened in the late fall was a departure from all of the communication patterns, the attempt to develop policy, that had occurred during my tenure. It was a dramatic change from the past.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

As I said earlier, I think the intention is to get the best value for the dollar. It seems that those multiple resignations are a protest over the role of the PMPRB towards the department and the ministry of health in general. Would you describe that as a protest?

[Prof. Matthew Herder]

My term would have ended this coming June. I was sufficiently concerned about what had happened with the minister and pressure from stakeholders that I wasn't sure I was able to do anything further inside.

I think there was division within the board, but there remain a lot of very dedicated staff who hope to follow through and improve prices in Canada for Canadians. It was a decision I struggled with greatly. The last thing I wanted to do was call into question the work of those colleagues for whom it is a full-time job. It was only a part-time job for me.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

That negative pressure from the government must have provided a major obstacle to the job of the board. Is that correct?

[Prof. Matthew Herder]

Yes. As I tried to stress, I think it has made the prospect of developing new guidelines—and other kinds of decisions the board might face in the future—very difficult, in light of what's happened.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Thank you, Mr. Chair.

I would like to defer the rest of my time to Mr. Kitchen.

[The Chair, Liberal, Sean Casey]

Go ahead, Mr. Kitchen.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you, Mr. Chair.

I'd like to move to resume debate on the motion presented at the last meeting.

[The Chair, Liberal, Sean Casey]

The motion before the committee is not debatable. It's a dilatory motion to resume debate on the motion we debated at the last meeting, so it is not debatable. We're going straight to a vote.

(Motion negatived)

You still have a minute and a half, Dr. Kitchen.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

I'll defer it back to Mr. Aboultaif.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Thanks again.

What measures do you think should be taken to assure that the board will be able to function with its own capability in the proper way in the future?

[Prof. Matthew Herder]

I think we have to make sure that the independence is actually safeguarded so that there can be lots of consultation led by the board with the minister and others and other parts of the government.

We have to remain the master of our own guidelines, for instance. Certainly there can be no interference. We need a recommitment to independence.

Part of that is the relationships some members have with industry, perhaps, through their day jobs. We need to take conflicts of interest much more seriously, as I said in my opening comments.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Mr. Clark, in a publicly published letter from MS Canada to this committee, it appears stakeholders are under the impression they have not been considered in decision-making processes in the last six years.

Would you believe other stakeholders and interest groups are under the same impression?

[Douglas Clark]

I think the stakeholder group is divided, on one hand, between private insurers, public payers, independent patient groups and academics who support reforms and feel they have been heard, and on the other hand, industry and industry-funded patient groups that feel they have not been heard.

Some of you know I testified on two occasions—in 2019 and 2020—during our last round of consultations. We undertook to provide a number of documents to the committee. I have some of them here, one of which shows all the changes we made over the course of that previous round of consultations in light of feedback from industry.

They were significant and substantive. In that period of time alone, we spent over 110 hours meeting with industry stakeholders, so I don't agree with that point. I believe the briefing note Mr. Davies cited at last Thursday's testimony.... The acting chair made the same point. The industry would come to every meeting and read out a disclaimer that they were there against their wishes and had no intention of engaging on the substance. Where does that leave you, in terms of an exchange of ideas?

I don't know.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Aboultaif.

Next, we have Mr. van Koeverden for five minutes.

[Adam van Koeverden, Liberal, Milton, ON]

Thank you, Mr. Chair.

Repeatedly throughout this meeting, the number 13 has been quoted with respect to pharmaceutical company consultations with the minister.

To either witness, do you recall anything happening across Canada last year with respect to analgesics that might have warranted some of those meetings with pharmaceutical companies? Also, are analgesics patented drugs?

[Douglas Clark]

I think you're referring to children's Tylenol. I think that's what the minister was alluding to in his letter to us, and of course it isn't a patented medicine. It doesn't have anything to do with products under our jurisdiction.