Evidence of meeting #26 for Health in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was patients.
A video is available from Parliament.
Bloc
Maxime Blanchette-Joncas Bloc Rimouski—La Matapédia, QC
I just want to fully understand the situation.
Canada accounts for 2% of the world's drug market. When you talk about opportunities, what do you mean?
Rolling out the red carpet for pharmaceutical companies is all well and good, but it comes at a cost. I'm trying to see how we can strike a balance and make sure that we remain as autonomous and sovereign as possible when it comes to pharmaceuticals, without necessarily taking risks with public funds and ultimately getting nothing in return.
Interim Vice-President, Public and Professional Affairs, Canadian Pharmacists Association
We also need to ensure that we have enough supply within Canada. The supply we are manufacturing in Canada shouldn't go out of Canada. It should be for Canadians first. That's what our policies should focus on: anything being made in Canada.
We need to have those incentives for manufacturers. If they are coming to Canada, there should be some guidelines or guardrails around that.
Bloc
Maxime Blanchette-Joncas Bloc Rimouski—La Matapédia, QC
In your opinion, is Canada currently getting good value for the investment of public funds?
I'm thinking in particular of our ability to secure help from the world's major pharmaceutical companies to produce certain drugs and take care of the public.
Interim Vice-President, Public and Professional Affairs, Canadian Pharmacists Association
I'm sorry. Can you repeat the question?
Bloc
Maxime Blanchette-Joncas Bloc Rimouski—La Matapédia, QC
Are we really getting our money's worth in terms of the public funds invested—people's tax dollars—and the contribution that we receive from the pharmaceutical industry in terms of access to certain drugs, prices and availability?
Interim Vice-President, Public and Professional Affairs, Canadian Pharmacists Association
I'm not sure I will be able to answer that question.
Bloc
Maxime Blanchette-Joncas Bloc Rimouski—La Matapédia, QC
Okay.
Do you know whether the drug prices in Canada are competitive with the drug prices in other countries?
Liberal
The Chair Liberal Hedy Fry
The time is up, Mr. Blanchette-Joncas.
Dr. Faisal, you can't answer the question Mr. Blanchette-Joncas just asked now, but could you get the information and send it to the clerk of the committee so that we can get the answer? It's an important question.
Interim Vice-President, Public and Professional Affairs, Canadian Pharmacists Association
Yes, I can.
Liberal
The Chair Liberal Hedy Fry
Thank you very much.
I now go to the second round, which is a five-minute round, and I'll begin with Mr. Strauss. He's not here. Who's going to do it? Is it Mr. Mazier?
Liberal
The Chair Liberal Hedy Fry
It's Ms. Jaczek. I'm sorry. It's Ms. Konanz. There are two Helenas and I get confused. Both are blond.
I am going to start with Ms. Konanz for five minutes.
Conservative
Helena Konanz Conservative Similkameen—South Okanagan—West Kootenay, BC
Thank you, Chair.
My question is for Mr. Judson. In this study of pharmaceutical sovereignty, we're looking at existing public investments in and purchases of Canadian-made pharmaceuticals. The Canadian government significantly increased its purchasing, supply and distribution of pharmaceutical-grade hydromorphone, particularly during the period of the failed B.C. decriminalization experiment.
Do you consider the federal government's purchasing of hydromorphone for so-called safe supply purposes to be public money well spent?
Addictionist, As an Individual
No, it's not money well spent at all. The hydromorphone that has been stockpiled is to be dispensed in pharmacies where patients are getting prescriptions for inordinately high concentrations of hydromorphone. Because it is short-acting, it effectively destabilizes the nervous system, making recovery virtually impossible. It's locking the patients into their addiction.
The fact that there is an abundance of hydromorphone available in Canada, even before it makes it into the pharmacy, means that the present policy is to keep on feeding pharmacies and encouraging doctors to prescribe hydromorphone. That is not the best recommended treatment. Safe supply is not safe when you look at the big picture. It may be pharmaceutical-grade hydromorphone, but it's not safe for the community with this amount of hydromorphone being diverted from patients when they leave the pharmacy.
Conservative
Helena Konanz Conservative Similkameen—South Okanagan—West Kootenay, BC
Okay. You're saying that there are definitely risks with increasing the supply, and it's not—
Addictionist, As an Individual
I can't say that it's the supply causing risk. It's because there are physicians who are prescribing it, and it's not the recommended line of treatment. In B.C., when safe supply first came in, it was for the administration of either tablets or injections of morphine under witnessed, supervised conditions three times a day.
Now, particularly in Ontario, it has degenerated into a daily dispensing of a day's supply of hydromorphone tablets, supposedly to be taken by the patient over the 24 hours, but we know full well, just by observation....
We can see that patients get their prescription of hydromorphone, take the first dose as a witnessed dose in front of the pharmacist and take the balance home. They're meant to take it throughout the day to prevent withdrawal and cravings, but instead, that is what they sell. It is diverted. That's where the danger is. It's not so much the supply that's then supplied in turn to the pharmacy; the problem stands with the physicians who are prescribing it.
Conservative
Helena Konanz Conservative Similkameen—South Okanagan—West Kootenay, BC
Would the investments made by the Canadian government in the distribution of pharmaceutical hydromorphone have been better invested in the production and distribution of pharmaceutical methadone and Suboxone, to be used for more opioid agonist therapy?
Addictionist, As an Individual
The drugs that are best used in the treatment of opioid dependence or addiction—it's the same thing—are methadone for severely addicted people and, perhaps a safer drug, Suboxone. Suboxone is now available in injectable form and can be administered once a month, but this means the patient goes into the physician's office once a month, gets an injection and leaves. With methadone they were perhaps attending the clinic twice a week, and that encouraged the buildup of an interpersonal relationship, which is perhaps the most therapeutic tool when it comes to treating addiction. It's not in a chemical. It's in developing a human connection and starting with that.
Conservative
Helena Konanz Conservative Similkameen—South Okanagan—West Kootenay, BC
The key is that the government needs to want to help people quit drugs as opposed to continuing on them. That would be the bottom line.
Addictionist, As an Individual
That's correct. If the money were spent not in the pharmaceuticals, but instead—
Liberal
Conservative
Helena Konanz Conservative Similkameen—South Okanagan—West Kootenay, BC
We only have a few seconds, if he could finish that—
Liberal
Addictionist, As an Individual
It would be better if the money were spent developing treatment programs rather than making it more readily available to prescribe hydromorphone.
