Health Committee on Sept. 27th, 2023

[Don Davies, NDP, Vancouver Kingsway, BC]

You've made a cost-benefit analysis report with respect to new labelling of products. Would you provide the committee with Health Canada's full cost-benefit analysis report?

[Dr. Supriya Sharma]

It's available publicly, but we can table it, yes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Okay. Thanks.

Canadians are currently permitted to bring personal use quantities of a natural health product into the country without requiring specific licences for the import. Do you expect that consumers will be more likely to import products from foreign jurisdictions if these regulatory changes by Health Canada lead to higher prices and perhaps reduce the availability of products in Canada?

[Linsey Hollett]

We know that it is a possibility. What we prefer and what is clear in our messaging is that our preference is always for Canadians to use NHPs that have been vetted by the department, that are safe and that are efficacious. While we realize that what you're saying may be a possibility, we already have quite a robust presence at the border. We do, as you say, allow for personal importation, but we are aware of the fact that this may occur—

[Don Davies, NDP, Vancouver Kingsway, BC]

A lot of Canadian businesses are telling me that's what's going to happen. They think prices are going to go up and products are going to be restricted, and a lot of foreign companies are not going to bother with the Canadian market because they don't want to retool. That will just result in Canadian consumers ordering things on the Internet. Are you proposing any new restrictions on personal use importation of natural health products? If not, why not?

[Linsey Hollett]

We are not at this time. One of the reasons is.... As you say, we have heard, like you, a lot on this topic. On one side, including us as a regulator, as I say, our preference is for Canadians to use products and buy products that have been approved by Health Canada.

However, we have another very vocal group within the country that is saying, “Maintain personal importation allowances,” and, “We want choice,” and, “If I choose to buy something from the United States or anywhere online, I want that choice.” There are two very vocal groups, so there's a very active discussion around finding a balance between those two positions.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Davies.

Next we have Dr. Ellis, please, for five minutes.

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

Thanks very much, Chair. There are so many questions to ask and so little time.

Through you, Chair, I find it interesting. These products are taxed. The tax revenue from this sector is about $2.3 billion, and you're telling me that you need $100 million more? That's insanity. How can you justify that?

[Dr. Celia Lourenco]

The cost-recovery proposal was developed based on the current cost of the program and the estimated costs with the improvements that we would like to put in place: improvements to inspections and to monitoring online advertising and just increasing resources in those areas to make sure products on the market are safe for Canadians.

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

I don't understand. That means it's $2.4 billion to run a program. Wow, that's a lot of money. It's an exorbitant amount of money.

I guess the other questions I have are related to looking at the scale of these issues.

I hate to say this. Do you know what? I was a family doctor for a long time. We talked about this nebulous number of 700 people who may have been harmed. Some of them, in the words of the minister, might have been admitted to hospital.

I'll follow along with what Mr. Fergus was trying to get at. Prescription drugs admittedly help tons of people, reduce mortality rates and make people live longer. I have a reference for you, if you would like, unlike what you have not been able to provide me: In this country, 50,000 seniors alone were admitted to hospital last year because of prescription drugs, which you already regulate. In the natural health products sector, 700 might have had an adverse event, and some might have been admitted to hospital.

I would suggest to you that we're talking about unnatural regulation. You're trying to regulate a sector that harms almost no people. It makes no sense. This is nonsensical—perhaps $2.4 billion of a budget. I can't even understand it. Also, not only are we going to regulate the natural health products sector in Canada into extinction—we're going to tax it to death—but we're also going to allow Canadians to continue to get medications and natural health products online from unregulated facilities elsewhere. There are no words for this.

I can understand why my colleague brings a small smattering of concerned citizens. Do you know what? This is part of the job. People come up to each of us in public and say, “How can you fight this so I can continue to get the vitamins, probiotics or prebiotics I want to have?” The scale of the issue is minuscule. I can't even understand this, or the money you want to recover. We've already heard from my colleague that the “right to sell” fee—which is one of the fees among an innumerable number of others—is up to $30 million and perhaps $100 million, because it's not simply what is sold. It's actually the licensed product, as I understand.

The amount of money you're asking of consumers is exorbitant. I can only attempt to understand how this government has driven Canada into the proverbial poorhouse and why we need to recover, out of the pockets of Canadians, another multiple billion dollars to fund the foolish spending of this government. I guess that's the only thing. To understand that very clearly is simply to follow the money and to ask, as well, that you table the number of people who are potentially having serious adverse events, some of whom have been admitted to hospital based on some nebulous concept and numbers that no one has been able to find. Trust me: We have searched very hard.

The final thing I would say, through you, Mr. Chair.... There isn't going to be a question here, thank you very much. I realize I have a timer on. The issue here is related to the fact that we're regulating something once again and trying to tax consumers further into the poorhouse when they can't afford to feed their families, put a roof over their heads or heat their homes in the coming winter.

From the bottom of my heart, thank you very much, Mr. Chair.

[The Chair, Liberal, Sean Casey]

Dr. Powlowski, go ahead for five minutes, please.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

I'm not going to make a political statement. I'm actually going to ask a question.

Dr. Ellis claims the cost of this program for the regulation of natural health products is $2.4 billion per year.

I'm going to give them the opportunity to respond to those allegations.

Tell me how much this is going to cost per year.

[Dr. Supriya Sharma]

Thank you, Chair, for the opportunity to respond to the non-question and the question.

Right now, it's a $44-million program. With the changes and the improvements, that will increase to a $100-million program, and we can go through all of those improvements. There are no billions; it's millions. We're not saying that it's an insignificant amount of money. It's a considerable amount of money, but it's the amount of money that we need to make the improvements for Canadians to go into a safe marketplace.

It's a bit like apples and oranges if you're comparing natural health products to pharmaceutical products, because it's all about risks and benefits. What are you treating? You will accept a risk associated with chemotherapy, for example, that you wouldn't necessarily with something that's to treat a headache, for example. It's all about risks and benefits, and what we really are striving for is having a regulatory system that has the appropriate level of touch based on the risk of these products.

What we've found is that there are some parts of the program that are functioning quite well: the premarket review and the standards that have been set. Again, I just want to clarify, because there's been some rhetoric around our all of a sudden changing the levels of evidence that we're looking for. We're not saying that. We're saying that there are some gaps. There are some gaps with respect to how these products are represented to Canadians. There are gaps and there are issues around the quality of these products. We've had 100 recalls over the last year and a half for fibreglass and bacterial contamination in these products. We have a concern around the advertising, the way that these products are represented and what they're claiming to do for people. We have concerns about the facilities.

There are gaps that we need to fill, and there are resources that we need for that. It is a $5-billion-a-year industry that doesn't pay any fees. These are not taxes; these are service fees, and for those service fees they also get accountability. They would get timelines and deadlines for the services that are provided to them, and it's not all of the cost. Australia cost recovers 100% of its costs for this product line. Ours is a portion of those costs.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Okay, so the allegation's been made here that this doesn't make sense. The quotation was that the number of people harmed, which is 700 over two years, is minuscule.

Don't you also have to factor in the number of people who are harmed by a claim that is untrue, for example, cancer patients who aren't getting their medications because they believe a product advertisement about a natural product being helpful? Does that not also have to go into the cost-benefit analysis when you look at people who are adversely affected by relying on a natural product that isn't proven? Is that not part of the equation in terms of the $100 million a year that's going to address this problem?

[Dr. Supriya Sharma]

It is part of it.

Again, I don't want to misrepresent these products. They are generally low-risk, but we had a tragic case of a 19-month-old in Alberta who died because of being given natural health products instead of treatment for meningitis. Dr. Steve Flindall is an emergency physician in Toronto who had a patient who was stable on medications for seizures but was taken off those medications and put on zinc. They went into status epilepticus, which is constant seizures, and died. It does happen.

Really the principle is that Canadians should be able.... They're self-selecting. They're self-selecting these products. They should have the assurance that they're going into a safe marketplace and that, when they're picking up a product, what's on the label is what's in the bottle; the advertising claims that are made are accurate; the quality of the product that's in that bottle is high; and the product is not going to be contaminated with bacteria or other things. That's the principle.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Thank you.

Do you know what the increase in price for your average natural health product is going to be as a result of the new cost recovery program?

If I'm buying my vitamin C or whatever I'm buying, what percentage increase of price will result from implementing these measures?

[Dr. Supriya Sharma]

If we look at all of the increased costs, it works out to $1.60 per Canadian total for all of the costs, and that's if every cent of those costs is passed along to the consumer.

Again, we have over 60% of these companies that are small and medium, but we have some very large companies as well. Again, we have fee mitigation for it, so—

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

I'm sorry; will it cost your average Canadian $1.60 more because of these regulations?

[Dr. Supriya Sharma]

It will, if we take all of the increased fees and we pass those directly on to Canadians.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Powlowski.

Next we'll have Dr. Kitchen, please, for five minutes.

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

Thank you, Mr. Chair. I appreciate that.

When you say $1.60 per Canadian, you're making it out as being for every Canadian, when not every Canadian uses the products.

Number two, the reality is that $1.60 doesn't include the tax that will be put on it by the inflationary costs that are being created by what you're putting onto the product, the $542 per product. On top of that, there are the costs that will be factored in when you start looking at the huge costs that you have on the premarket evaluation, which can range up to $50,000 plus.

When you say $1, you're basing it on a very small factor of the taxes being put on there. The costs that the producer is going to have to put on.... As my colleague indicated, when you grow the food and you tax the farmer and then you tax the transporter, those costs come down on the consumer and on the individual. Those costs are high.

You talked about inspecting facilities and you sort of indicated “inspection-like”. The question I have is this: How many have you done?

[Linsey Hollett]

Under the pilot program that I mentioned, we did 36.

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

You did 36 since 2004.

[Linsey Hollett]

That was 36 in one year of the pilot, in 2021-22, but since that time, we've done another 39, and we have 37 more planned between now and March 31.

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

You do 37 a year. That's what you're saying at this point in time. That's it, out of—