Health Committee on April 23rd, 2026

[Maggie Chi, Liberal, Don Valley North, ON]

Thank you to all the witnesses who have come today to testify as part of this very important study.

My first question is for Ms. Donaldson. Thank you so much for coming.

I read online that your organization does procurement for medicine and equipment. You also mentioned that during COVID, our supply was exposed as a big vulnerability for our country.

From both perspectives—for medication and the supply of equipment—what are some of the good lessons and take-aways we have learned in working with partners, governments and hospitals that can help strengthen that chain? As well, what are some of the steps you've seen that have better prepared us for the next round—knock on wood—in case another COVID happens?

[Christine Donaldson]

You're right that there are many lessons learned through any type of risk to or any type of stress on our supply chain. What we've done is collaborate on a different level.

I think the national agenda has shifted. As a national organization, we work very closely with many provinces, as you said, on all kinds of critical supplies. Today, that could be a medication, but tomorrow it could be an OR product, a medical device. It's about understanding the true source of the issue, number one.

Number two is that as we start to collaborate, it's about understanding how to make things more predictable. We've heard about encouraging domestic suppliers. They need predictability, and this opportunity for us to band together as a national voice and bring our volumes to the market is critical for their sustainability, as well as for the demand forecast that I mentioned earlier. We need that planning. That's often why we run into these issues, even during non-critical and non-crisis time periods.

Those lessons learned can continue to serve us, but only when we have our national strength. Again, a national policy will help us to reinforce that agility and some of that resiliency, and, as we heard earlier, make it a faster and more streamlined process, particularly for the products at risk.

We're talking about pharmaceuticals here, but it can be any of those products as well.

[Maggie Chi, Liberal, Don Valley North, ON]

On the procurement side, I imagine you probably deal with the regulatory process and the policies on that side quite a bit. As a federal government, we can concretely say that we can take steps now. What are the signals you've received that say there are some positive changes within the regulatory environment?

[Christine Donaldson]

The positive changes, I think, would be interacting on a coordinated approach. We recently had engagements with HERC, health emergency readiness Canada. It's still in its beginning days, but there's been quite a bit of excitement around that strategy to work with both the Public Health Agency of Canada and Health Canada and to take that forward in a more proactive approach than we have had in the past.

We have tremendous experience and history. We've been in this business for 30 years, so we have data that could help assist us through many of the ups and downs in the pressures within our fragile supply chain.

We are very keen to continue working with the federal government and all the stakeholders we represent. Our suppliers and the manufacturers out there are keen to understand. They really do want a little more stake in the future, and I think the risk perspective and the risk sharing have also shifted.

[Maggie Chi, Liberal, Don Valley North, ON]

Thank you so much for that.

Mr. Thibeault, thank you so much for coming.

This is part of your core advocacy. As you mentioned, we invented insulin and played a big part in advancing GLP-1, and you mentioned that we don't produce either of those. It's Canadian IP, yet we don't make money off of it.

From your perspective, tell us a bit about what you see as the biggest gaps and what we can do to address those.

[Glenn Thibeault]

We can continue to talk about how we can work together as stakeholders, patient voices and Parliament to look at the types of policies that will ensure we're protecting people in Canada and ensure that they get the medicines they need.

There's an open invitation for everyone to come out to Peter's riding to see Banting House and see where it started, because it truly is important. We created it and we invented it. Let's make sure we start producing it here in Canada so that no Canadian will ever have to go without medicine that keeps them alive.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

I want to thank our witnesses for coming in and shedding a light on an essential and critical issue for our patients and our constituents in this country.

I also want to thank you for reminding us of our history with diabetes. We talked about Banting and Best, but we have forgotten a very important Nobel Prize winner from UBC, Michael Smith, who created synthetic insulin so that we didn't have to depend on beef and pork insulin.

We are a leader, especially in diabetes, but Canada has always been a leader in biomedical sciences. We've always done the R and D. We did it, and you're right that what we didn't do was take it to the next stage of manufacturing it ourselves, so we didn't make any money. We did the work; other people made money on it.

I want to flag one thing quickly. Two weeks ago, the Minister of Industry delivered money to a small company in my riding called Aspect. They have been able to 3-D print islets of Langerhans cells, and they can now insert them into a type 1 diabetes person at birth so they can make their own insulin. This is what Canada is doing.

I want to thank you for making us feel proud today to be Canadians. We as a committee should point to the next steps to make some money out of what we do and make sure, as you said, to look not just at affordability but also at availability as a core problem.

Thank you so very much for coming.

We will suspend until we get the next witnesses onboarded.

[The Chair, Liberal, Hedy Fry]

I would like to resume the meeting. Thank you.

I would like to welcome the witnesses joining for the second hour. From BioCanRx, we have Stéphanie Michaud, president and chief executive officer. From the Canadian Association for Pharmacy Distribution Management, we have Angelique Berg and Simona Zar, senior vice-president. Then we have, from the Neighbourhood Pharmacy Association of Canada, Sandra Hanna, chief executive officer.

We have a very hybrid meeting today.

I just want to begin by welcoming you as witnesses. Also, I want to give you a bit of housekeeping.

There are two of you representing one group. You only have five minutes. You can split it, or you can decide who is going to do the presentation.

Each group has five minutes to present. I will give you a one-minute shout-out and a 30-second shout-out so that you can wrap up. If you don't think you got to say everything you wanted to say, there's going to be a question and answer session in which you will be able to expand. I'm sure the members sitting here will feed you questions so that you can expand on what you're trying to tell us.

We now begin with Stéphanie Michaud for five minutes, please.

[Stéphanie Michaud, President and Chief Executive Officer, BioCanRx]

Madam Chair, members of the committee, it's an honour to appear before you today.

I'm speaking in French to emphasize what's already at the heart of my approach, namely that pharmaceutical sovereignty is also a country's ability to tell its own scientific story and to write its next chapter.

I'll continue my remarks in English.

My name is Stéphanie Michaud, and I'm the president and CEO of BioCanRx, Canada's immunotherapy network, a federally funded organization that has spent the past decade doing something that Canada does not do nearly enough: taking world-class Canadian cancer research and turning it into actual therapies for actual patients.

I want to use my five minutes to challenge one assumption embedded in how the study is framed. I say this with respect, because I believe it matters enormously for the recommendations this committee will make.

Pharmaceutical sovereignty is most often discussed as a supply chain problem: How do we ensure Canadians can access medicines when global supply is disrupted? That framing accepts as a starting condition that Canada will continue to depend on therapies created elsewhere. The deeper question, the one this committee has an opportunity to address, is this: Why isn't Canada creating more of those therapies itself?

Between 2002 and March 2026, only 3.4% of cancer immunotherapy clinical trials conducted in Canada were based on made-in-Canada innovations. Canada is the only G7 country without a domestic pharmaceutical company producing novel medicines. It's not because our science is weak—it is world-class—but because we have built a federal funding and governance system that is very good at funding the first chapter of a discovery, and then stops.

In December 2025, BioCanRx commissioned the Institute on Governance to benchmark Canada's translational ecosystem against that of six peer countries. The finding was unambiguous: Canada's underperformance is not a science gap; it's a governance gap.

Advanced therapies—the cell and gene therapies that represent the next generation of cancer treatment and, increasingly, treatment for metabolic and other diseases—fall structurally between federal mandates. The work required to move a Canadian discovery to a clinical trial—the GMP value manufacturing, the toxicology studies, the regulatory dossier—is too applied for federal health research funding and too risky for private capital. It falls into a gap, and nothing catches it.

We lived this problem directly. In 2023 and 2024 federal clinical trial competitions, three BioCanRx projects were selected for funding and could not proceed. They could not file a clinical trial application to Health Canada because the regulatory preparation work had never been funded. These projects sat idle for more than a year, and there was no federal mechanism designed to bridge the gap.

We stepped in as an organization due to our funding in the strategic science fund. One of those projects has now opened a clinical trial offering a CAR T therapy to both pediatric and adult blood cancer patients, a therapy that has not existed in Canada before.

About two weeks ago, the Government of Canada announced a $280-million commitment to support Aspect Biosystems, a Vancouver company developing bioengineered cellular medicines targeting diseases, including type 1 diabetes. That is exactly the model Canada should be building. It's Canadian science and Canadian manufacturing integrated with global expertise, but it is remarkable precisely because it is rare.

BioCanRx is asking this committee for three things.

First, redesign the scope of the study. Pharmaceutical sovereignty must mean the capacity to create novel therapies, not only to secure supply of existing ones.

Second, fill the structural gap. Canada needs a permanent milestone-driven translational health research program that funds the work currently falling between mandates, including the regulatory preparation that federal clinical trial funding currently leaves unfunded. CIHR should not fund a trial that cannot proceed. The IOG has made this recommendation, and we are here to reinforce it.

Third, publish a strategy with real accountability: a framework with milestones aligned across Health Canada, ISED and federal research bodies, and a coordination mechanism so that Canadian innovators are not navigating this alone. The committee's task is to make success the system, not the exception.

Canada discovered insulin. Researchers trained at the University of Alberta pioneered the science behind CAR T-cell therapy. Canadian science is not the problem. The problem is that we continue to invest heavily in the first chapters and leave the rest unfunded. The result is that Canadians with cancer are accessing therapies created from Canadian science in other countries' clinical trials and manufactured in other countries' facilities. That is not sovereignty.

I'm asking this committee to help us build this.

Thank you. I welcome your questions.

[The Chair, Liberal, Hedy Fry]

Thank you very much. That was well within the five minutes.

I now go to the Canadian Association for Pharmacy Distribution Management.

Ms. Berg is going to be the speaker.

You have five minutes, please, Ms. Berg.

[Angelique Berg, President and Chief Executive Officer, Canadian Association for Pharmacy Distribution Management]

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.

[The Chair, Liberal, Hedy Fry]

Thank you very much, Ms. Berg.

I now go to the Neighbourhood Pharmacy Association of Canada and Ms. Hanna, chief executive officer.

You have five minutes, please, Ms. Hanna.

[Sandra Hanna, Chief Executive Officer, Neighbourhood Pharmacy Association of Canada]

Thank you, Madam Chair and honourable members of the committee, for the opportunity to speak with you today.

My name is Sandra Hanna. I'm the CEO of the Neighbourhood Pharmacy Association of Canada. I'm also a third-generation practising pharmacist and the former owner of an independent pharmacy, where I worked directly with patients and Canadians to manage medication access and continuity of care.

The Neighbourhood Pharmacy Association represents the delivery of care through more than 12,000 pharmacies across Canada, including independent, chain and specialty pharmacies, as well as those in grocery and mass merchandisers. About 95% of Canadians live within five kilometres of a pharmacy. They are Canadians' most frequent and often first and last point of contact with the health care system.

We describe pharmaceutical sovereignty as ensuring a stable and secure supply of medicines for Canada, and that is critical, but from a pharmacy standpoint, sovereignty has to also include and be measured by whether the supply actually reaches patients, because only then do we achieve true access. Access cannot be defined by manufacturing, procurement, funding and coverage alone. It depends on the infrastructure that reliably delivers medicines to patients. That infrastructure is the pharmacy sector, where patients find out whether their medications are available, delayed, substituted or rationed, and where upstream disruptions become real and can cause harm.

In a globally integrated and increasingly unstable environment, pharmaceutical supply is a matter of national security, and pressures are felt most directly at the point of care. Pharmacies are a stabilizing layer of the system when disruptions occur. Pharmacies manage shortages in real time, work with prescribers to adjust therapies, source alternatives, manage inventory to protect the most vulnerable patients and support adherence when disruptions inevitably occur.

In many cases, patients remain on therapy not because the system is completely stable, but because pharmacies are actively stabilizing it alongside distributors, yet this role is not fully reflected in how pharmaceutical policy is designed. We often treat Canada's pharmaceutical supply as though it was centrally managed. In reality, it is fragmented and price-driven.

Medicines flow through manufacturers, wholesalers, group purchasing organizations and pharmacies, with public and private payers shaping demand. At the same time, global pressures are increasing fragility. Manufacturing is centralized in fewer regions, active pharmaceutical ingredient production relies on a limited number of suppliers and geopolitical uncertainty is growing.

Pharmacies sit at the end of this chain. We don't directly control supply, but we are accountable for ensuring that every Canadian receives the medications they need. We use real-time data, understand local demand and continuously adjust inventory to maintain access. We are often the first to see signs of strain, including demand spikes, sourcing challenges and early ripple effects from global disruptions. This is a critical and often invisible part of the system working at its best, yet these insights are not systematically used in national policy, planning or response.

Pharmacies must be a part of the design of an integrated, system-level solution that leverages real-time insights across the full supply chain. These are not individual business tools, but rather coordinated system infrastructure. If pharmaceutical sovereignty is about resilience, pharmacy-level insights must be part of the core system infrastructure. The last mile matters.

Pharmacies are also a core part of Canada's life sciences ecosystem. We operationalize new therapies, support appropriate use and contribute to postmarket monitoring by identifying early issues with new medicines. Despite this, pharmacies are rarely included in pharmaceutical policy or strategy discussions. If Canada is serious about pharmaceutical sovereignty, a whole-system approach must include the delivery layer where access is actually realized.

In closing, I have a few considerations for the committee. In addition to reinforcing domestic manufacturing and redundancies for critical medicines, as others have noted, we encourage you to think a bit more broadly.

First, recognize pharmacies as critical health care infrastructure and include us early and often in pharmaceutical policy, pricing and strategy discussions. Second, improve supply chain visibility, including at the pharmacy level, to build a more integrated and responsive system. Third and last, enable flexibility for pharmacists to manage shortages through therapeutic substitution across all medicines, supported by federal recognition of pharmacists as practitioners.

Pharmaceutical sovereignty and, increasingly, national security are about ensuring that Canadians have uninterrupted access to the medicines they need, and pharmacies are on the front line of that responsibility. We look forward to supporting this work with real-time insights from the front lines and contributing to a system that is reliable, sustainable and responsive to the needs of Canadians.

Thank you.

[The Chair, Liberal, Hedy Fry]

Thank you, Ms. Hanna.

Now we're going to the question and answer session. It starts with six minutes, and the six minutes include the questions and answers.

I'll begin with Mr. Strauss for the Conservatives for six minutes.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Thank you, Chair. Could you kindly let me know when I have one minute left on your clock?

[The Chair, Liberal, Hedy Fry]

I will let you know when you have one minute and 30 seconds.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Thank you.

Ms. Hanna, thank you for that introduction to your organization and the importance of pharmacies as the last mile of pharmaceutical sovereignty, as you described it.

Our committee has taken an interest in the e-prescription program that the federal government has funded to the tune of $300 million so far, called PrescribeIT. Were you or members of your organization using that program? Was it working successfully?

[Sandra Hanna]

Yes. Many of our members were using the program and were signed on to the program. I, personally, was also using the program. It was an important tool, yes.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Would you say it was contributing to Canada's pharmaceutical sovereignty in that sense?

[Sandra Hanna]

It was contributing, certainly. It was the right idea. It was certainly the right direction. Unfortunately, we didn't see the uptake that we would have hoped to see with this type of program.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Were you paying to use the program?

[Sandra Hanna]

Towards the end, we were. It was originally funded federally. Towards the end, when federal funding was ceased, funding was moved over to pharmacies with the new model for PrescribeIT.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Do you know to whom those funds were flowing?

[Sandra Hanna]

I can't say for sure. Pharmacies were invoiced by PrescribeIT for a transaction fee.

[Matt Strauss, Conservative, Kitchener South—Hespeler, ON]

Do you know how much that transaction fee was?