Health Committee on March 26th, 2026

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Thank you, Madam Chair.

First of all, Dr. Burnell, thank you for coming.

We were talking about clinical trials. We've been talking a lot about how this is one of the essential parts of developing new drugs. They're the first pathway through which patients can access new therapies for things like cancer and rare diseases, and they can attract global research to Canada. We apparently have an opportunity right now, given that in the current political climate, we're looking at medical practitioners and researchers from America who are looking for other places to practise and work.

Health Canada recently launched some consultations on a framework to modernize our clinical trial regulations to make them more flexible with risk-based regulatory oversight. Why are these clinical trials so important? Can you give more detailed answers on why we need this in Canada?

[Dr. Margot Burnell]

Clinical trials are very important. The reason is that medicines, when they enter into practice, are tested. First of all, are they safe for individuals? What is the appropriate dosing? What is the appropriate interval of dosing? What are the anticipated side effects? We need what we call phase one trials to determine this.

Phase two trials are then tested in patients with the indication that the drug is supposed to benefit. If it's a patient with breast cancer, the phase two trial will take individuals with advanced breast cancer; the drug will be administered to see if it's effective. If it meets the threshold predetermined in the phase two trial, it proceeds to a phase three trial.

A phase three trial compares the new drug with the current standard of care for efficacy and safety, as well as cost-effectiveness, in that order. Safety and toxicity are balanced. If you have a very effective drug but it has a lot of toxicity, then we need to know that. This becomes a discussion about whether you advance the drug and what you describe with patients when you administer or discuss using the drug for their illness.

Phase four is postmarketing studies. They look at reporting adverse events that occur in individuals once you open it up to a larger patient population. Individuals who enter clinical trials are very well screened. They have very tight eligibility criteria. When the drug enters a broader market, other toxicities may come to light.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

All right. Thank you.

Physicians will see gaps in access to medications. We're hearing this a lot. Can you speak to the challenge your members are hearing right now about what's happening in terms of whether we have a relative lack of pharmaceutical sovereignty and how clinicians are saying this is affecting their patients?

[Dr. Margot Burnell]

We hear from individuals that shortages occasionally happen across this country. In the medical oncology field, which I'm most familiar with, a product may not be available from a given company, and therefore we need to source a similar product from a different company. We may need to adjust a drug dosage that has been determined to be effective in order to conserve on drug availability.

This takes time and effort. We have to adjust what our normal paths of distribution are in prescribing within our clinics and our discussion with patients.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Thank you.

Madam Chair, how much more time do I have?

[The Chair, Liberal, Hedy Fry]

You have one minute and 30 seconds, Doug.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Thank you, Madam Chair.

This question is also directed towards Dr. Burnell.

We are hearing a lot about the different changes regarding the economic and political problems, particularly in regard to tariffs and the disruption of trade because of them. Have your members in the CMA been reporting any increased difficulty in access to medications since the recent actions of the U.S. government in their approach to trade?

[Dr. Margot Burnell]

There have been discussions, I understand, between the pharmaceutical industry and Minister LeBlanc with respect to these issues.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Thank you.

Is it too soon to tell on the ground, as it were, whether clinicians are seeing any effects on how their patients are being treated?

[Dr. Margot Burnell]

Drug costs over the course of time increase a given percentage per year, which is budgeted for by health authorities. It is hard to attribute a percentage for any given year to being affected by geopolitical events.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Thank you.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

I now go to the Bloc Québécois.

Monsieur Blanchette-Joncas, you have six minutes, please.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Thank you, Madam Chair.

I would like to extend my greetings to the witnesses here today.

My first question is for Ms. Trudeau.

In your opinion, is Quebec fully benefiting from the economic spinoffs of its pharmaceutical research, or is it failing to capture a significant portion of this value?

[Arianne Trudeau]

First, Médicament Québec doesn't necessarily work on promoting innovations that stem from research partnerships or university research. However, a great many studies have been carried out to show that this situation isn't unique to Quebec. This is happening across Canada. We're seeing a certain valley of death.

On the one hand, the pharmaceutical value chain contains a valley of death. It takes an enormous amount of capital to move innovations from one link in the innovation chain to the next. On the other hand, we lack certain links that would enable us to better harness this value and work together more effectively to move projects forward.

When we talk about developing clearer strategies and clear guidelines for pharmaceutical sovereignty, we're also talking about government guidelines for strengthening one key sector versus another. However, we also need to become clients of these innovations. We need to become the first users of innovations made in Quebec or Canada, so that society as a whole can benefit from them.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Ms. Trudeau, in terms of strategy, when public funds support pharmaceutical research in particular, should we impose conditions to ensure that the economic benefits stay here?

[Arianne Trudeau]

Indeed.

This is one reason why Médicament Québec advocates in particular for collaboration. This collaboration makes it possible to secure and optimize investments in pharmaceutical research. It helps to ensure that, if we invest in a company, an academic partner is also involved. If, for some reason, the company goes bankrupt and gets sold, an academic partner still tends to stay on.

We experienced this in the 2000s, when the big pharmaceutical companies left. The pool of talent and highly qualified employees remained in Quebec and, in many cases, retrained in academia. This would be one way to better reap the benefits of our investments.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Understood. Thank you.

Given your expertise, do you believe that the model that Canada currently uses makes it more dependent on the decisions of foreign multinationals to design and produce its own drugs?

[Arianne Trudeau]

This is largely the case. Pharmaceutical ingredients often come from China, India or other pharmaceutical companies. As you no doubt know, drug supply chains are extremely complex. Of course, the current geopolitical situation is only making them more complex.

To get the most out of supply chains, we really need to determine the niches to focus on and then develop them. However, we need to make decisions. We can't be good at everything. The Canadian market is too small to be good at everything. We really need to make some strategic choices here.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

I completely agree.

I love the strategy of consistency. In your opinion, are Canadian policies consistent in terms of research funding, tax incentives and industrial objectives?

[Arianne Trudeau]

I think that things are getting better and better at this stage. I think that we're increasingly looking at impact research and targeted research. We're talking about mission‑oriented research. We're really talking about generating actual benefits. We're talking less about basic research, and more about applied research.

That said, we mustn't forget basic research either. It fuels the rest of the process.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Understood.

You said that things are getting better and better. As far as I know, Canada is the only G7 country that failed to produce its own vaccine against COVID‑19.

What steps have you taken to analyze the benefits showing that things are getting better or that pharmaceutical sovereignty is gaining ground in Canada and even in Quebec?

[Arianne Trudeau]

Indeed, the current ecosystem is highly fragmented. In other words, there are a significant number of small players. Once again, this stems from the departure of the major pharmaceutical companies. Of course, we can't necessarily compete with countries where the major pharmaceutical companies are well established.

We can't compete with China or India on the price of pharmaceutical ingredients either. Canada must really adopt a differentiation strategy. Once again, public policy must reflect these choices and help to truly support the benefits of research carried out here in Quebec.

[The Chair, Liberal, Hedy Fry]

Thank you. The time is up.

I now go to the second round, which is a five-minute round with Mr. Mazier for the Conservatives, please.

[Dan Mazier, Conservative, Riding Mountain, MB]

Thank you, Chair.

Ms. Hughes, in 2022 Grifols signed an agreement with Canadian Blood Services to collect plasma from blood donations. Has the entire signed agreement ever been made public, yes or no?

[Mary Hughes]

Madam Chair, no.