Thank you for the invitation to appear today.
I'd like to use my opening statement to pose some questions that I hope will inform the committee's inquiry.
The first question is about the PMPRB's independence.
When he appeared before this committee last week, Minister Duclos claimed his decision to not consult with the board prior to November 28, 2022, was driven by a desire to protect the independence of the board. According to his testimony, when he finally wrote the acting chair of the board on November 28, he was simply exercising his duty to consult with the board under subsection 96(5) of the Patent Act. Why wait until the eleventh hour to consult with the board?
The minister had not been briefed by the PMPRB about its reforms on any occasion during his tenure. In what way does his request that we suspend our consultations—a step no previous minister of health has taken—help protect the board's independence?
Under section 96 of the act, it is the board that has the legal authority to make guidelines. During the fall consultation period, the industry publicly called for the board to suspend its consultations without naming what its concerns actually were. Instead, the industry went to the minister to ask him to repeat its request that the board suspend its consultations. The minister did exactly that, without ever meeting with the board to gain an understanding of the proposed guidelines. In this environment, how can the PMPRB credibly consult on guidelines in the future?
The answer is that it can't. Industry now knows it can bypass the PMPRB when it isn't satisfied with the board's policy direction and can get the minister to do its bidding. It is an arrow straight to the heart of the board's supposed independence.
My second set of questions is about influence, specifically industry's pervasive influence on pharmaceutical policy in Canada.
Look no further than the PMPRB itself. Several former officials have turned their time at the regulator into consulting careers, despite the fact that they are prohibited, under the Conflict of Interest Act, from acting in a manner that takes “improper advantage” of their time in office. One former executive director of the PMPRB moved to a VP position at Innovative Medicines Canada, only to return to Health Canada a few years later. She is, today, the head of Health Canada's Office of Pharmaceuticals Management Strategies and the lead official advising the assistant deputy minister, the deputy minister and the minister on all PMPRB-related matters.
There appear to be direct lines of communication between Health Canada and industry. Days before any public announcement was made about our resignations, pharmaceutical lobbying firms knew we were stepping down from the board. The newly appointed chair of the PMPRB is a practising lawyer with clients actively engaged in the development of patented medicines. How was the new board chair appointed, given these potential conflicts of interest? How did lobbyists know the executive director and I were stepping down? Did someone at Health Canada advise the minister not to meet with the PMPRB last fall?
My point is that the line between consultation and conflicts of interest has become completely blurred under the industry's influence. Unless we start taking conflicts of interest far more seriously, meaningful pricing reform will be impossible.
Finally, I want to raise a fundamental question about political courage in the face of industry's power. You have heard different accounts of what happened at the PMPRB. It's important for the truth to come to light, but it should not distract us from the larger issue.
I urge the members of this committee, Parliament and Canadians more broadly to remain focused on industry's power to control the policy conversation. They control it by playing fast and loose with the facts. They say pricing reforms will hurt research and development, but the evidence shows that the pharmaceutical industry's spending on R and D is already at an all-time low, and this in the absence of pricing reforms. Industry says pricing reforms will stop life-saving therapies from being launched in Canada, but the evidence suggests that almost all new drugs launched in the U.S. also make it to Canada. Trikafta, the cystic fibrosis drug, whose manufacturer threatened not to launch in Canada as a result of the PMPRB's pricing reforms, was actually exempt from our new pricing regime, yet industry continues to claim the PMPRB was to blame for Trikafta's delayed availability in Canada.
The industry plays fast and loose with the facts because patients are desperate for new therapies and because they pay the leaders of patient advocacy organizations to sell the line that the PMPRB is the problem. Industry plays fast and loose with the facts because they can and because we let them.
The question we should all be asking is this: When will we ever stand up to industry's power and take the steps that are needed to make medicines more affordable for Canadians?
Thank you. I welcome your questions.