Thank you, Madam Chair.
Thank you to the members of the committee for the opportunity to appear today.
My name is Angelique Berg, and my colleague, Simona Zar, and I appear on behalf of the Canadian Association for Pharmacy Distribution Management. We represent Canada's pharmaceutical distributors, which deliver the majority of medicines across the country to community pharmacies, hospitals and other points of care. With their trading partners, they represent the actors in the supply chain that actually touch the product. The theoretical hits the road in this supply chain.
We believe that the pharmaceutical sovereignty strategy requires a solid understanding of that supply chain, domestically and globally, to anticipate the impact of decisions on Canadians' access to medications. We are pleased to be at your service, and we commend this initiative.
For those who are unfamiliar, pharmaceutical distributors play a critical role in medicine supply. They streamline orders and deliveries between hundreds of manufacturers and over 12,000 points of dispensing. They manage thousands of products, from the most shelf-stable to the most sensitive across therapeutic categories. They hold buffer inventory to absorb shocks. They resolve most disruptions and shortages—if you can imagine—before the patients feel them. They operate in a stringently regulated environment. They serve Canadians in every province and territory, from downtown centres to remote communities, across all kinds of geography and in any weather.
Distributors connect policy to delivery. Distributors ensure physical access to medications. From their position in the middle of the domestic supply chain, they have a national, system-wide vantage point up and down the supply chain in Canada. This affords a view of pressures and opportunities that can help inform the pharmaceutical sovereignty strategy.
Based on that experience and that viewpoint, we offer three recommendations for the committee's consideration.
First, the strategy can view the domestic supply chain as a vital, enabling system, and it is. Policy decisions on pricing, procurement and manufacturing can be strengthened by including consideration of the cost of physical access to medicines. This is especially important for remote and rural communities. I'll give you an illustration. The average distribution funding for a bottle of a cardiovascular protective agent—let's say, atorvastatin—is less than the price of a postage stamp, regardless of whether it is delivered to downtown Ottawa or Moosonee.
There is also great opportunity for public-private collaboration. This could include partnerships on reimagined vaccine distribution and strategic stockpiling initiatives, leveraging not only the formidable existing infrastructure, but also the supply chain's vast expertise.
Second, domestic manufacturing incentives can focus on reducing cost, risk and time to market, with a close eye on the buy Canadian initiative to guard against worsening shortages before things get better. Strategic incentives behind the scenes that enable all of the pharmaceutical supply chain, such as regulatory and licensing streamlining, faster Health Canada approvals and quicker public drug plan approvals, can improve resilience without losing alternative suppliers that are critical in our transition.
Third, Canada imports roughly 70% of its medicines, and new manufacturing facilities can take years to build, so we need a starting point that preserves patient access, as other witnesses mentioned. Canada can focus domestic manufacturing on a targeted short list of imported critical medicines whose interruption poses serious risks to patient health and whose shortages are already common. There are existing, credible resources that offer a good start, including Health Canada's critical and vulnerable drug list.
We see an immense opportunity here for Canada. The pharmaceutical supply chain is a strong, critical part of the enabling support systems for the strategy, and there's a strong foundation in place. We are committed to working collaboratively with government and partners across the system to build on it.
Thank you for the opportunity to share our perspective.