Health Committee on May 7th, 2026

[The Chair, Liberal, Sukh Dhaliwal]

I call this meeting to order.

Welcome to meeting number 34 of the House of Commons Standing Committee on Health.

Today's meeting is taking place in a hybrid format, pursuant to the Standing Orders.

Please wait until I recognize you by name before speaking. For those participating by video conference, please click on the microphone icon to activate your microphone, and please mute yourself when you are not speaking.

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As a reminder, all comments should be addressed through the chair. For members in the room, if you wish to speak, please raise your hand. For members on Zoom, please use the “raise hand” function. The clerk and I will manage the speaking order as best we can. We appreciate your patience and understanding in this regard.

On behalf of the committee members, I would love to welcome Kristina Tesser Derksen to the committee, and Aslam Rana as well, and earlier, I forgot Jake, who has joined us.

Pursuant to Standing Order 108(2) and the motion adopted by the committee on Tuesday, September 23, 2025, the committee shall resume its study of Canada's pharmaceutical sovereignty. On behalf of the committee members, I would like to welcome our witnesses.

From the Best Medicines Coalition, we have Kim Steele, who has joined us by video conference.

Welcome, Ms. Steele.

From the Canadian Health Food Association, we have the vice-president, government relations and regulatory affairs, Ms. Sonia Parmar.

Ms. Parmar, welcome.

From GPIM, we have the general manager, Stéphane Lévesque.

Mr. Lévesque, welcome to the committee.

Now I'm going to give the floor to the witnesses in the sequence that I introduced them in.

We will give Ms. Steele five minutes, if you're ready, Ms. Steele.

[Kim Steele, Chair, Best Medicines Coalition]

Members of the committee, thank you.

I'm here as chair of the Best Medicines Coalition, a national alliance of over 30 organizations that gives voice to the interests of millions of Canadian patients. I'm also with Cystic Fibrosis Canada, a member of Best Medicines.

When we talk about pharmaceutical sovereignty, we often focus on manufacturing, supply chains, strategic interdependence and tariff exceptions, and those are all important, but sovereignty must also address something much closer to our everyday lives, which is how we get the medicines we need as Canadians to survive and thrive. Every Canadian needs some form of pharmaceutical coverage, but Canada's complex, fragmented mix of public and private drug plans undermines sovereignty. We have 14 sovereign public drug plans and over 100,000 sovereign private drug plans. All operate with different rules, formularies and timelines, making it impossible for Canada to act as a coherent nation. This in turn weakens our ability to ensure predictable access to medicines. If we are to move forward with sovereignty, extending similar drug access rights to our own citizens would be a good start.

Much of the current discussion on pharmaceutical sovereignty has focused on essential medicines and generics. While critically important, this focus is incomplete. Innovative medicines, including biologics, oncology therapies, cell and gene therapies, and drugs for rare diseases are equally essential and must be explicitly included in Canada's sovereignty strategy. Innovative therapies are often the only options for people with rare diseases, as are clinical trials, including rare cancers. Delays at any stage for regulatory review, clinical trial start-up, health technology assessment or reimbursement can mean missed treatment windows, irreversible disease progression and premature death.

Cystic fibrosis provides a stark example. Trikafta is a life-changing therapy that benefits more than 95% of the Canadian cystic fibrosis population. Within two years of access in Canada, days in hospital were reduced by nearly 40%, home IV days using antibiotics were reduced by 60%, and lung transplants were reduced by almost 70%, yet this transformational therapy came to Canada two years after people in other countries got it. Why? It was because prolonged uncertainty around proposed pricing reforms delayed the manufacturer's decision to launch in Canada. While patients elsewhere got better, Canadian patients with cystic fibrosis waited, watched and grew sicker, and we lost some who were waiting for this medicine to come.

These experiences are not unique to cystic fibrosis. When it comes to access to medicines in Canada, uncertainty is everywhere. Pharmaceutical sovereignty is not achieved through good intentions. Countries that take sovereignty seriously rely on clear laws, regulations and incentives to ensure that medicines are developed, launched, studied and supplied in their countries. That predictability enables patient access and signals to innovators that a country and, most importantly, its people are worth investing in.

The U.S. Orphan Drug Act is a powerful example. Implemented in 1983, it established market exclusivity, tax credits, grants, priority review and the elimination of FDA application and user fees for orphan drugs. Another U.S. initiative is the transferable priority review voucher, which accelerates access to future therapies. If used in Canada, these vouchers may have helped close the access gap to Trikafta and many other innovative therapies. These incentives were written into law, and they have transformed rare disease drug development throughout the globe. Ironically, some of the therapies developed under that framework are the same ones that Canadians can't access right now, because we have not implemented similar initiatives.

If Canada wants innovative medicines to be developed, studied and accessed here, we need laws and policies that actively support patient access. At minimum, pharmaceutical sovereignty must deliver four things. One is a reliable and continuous supply of medicines across all therapeutic areas. Two is timely access to innovation, including faster regulatory approval and market access. Three is equitable access across jurisdictions and payer types. Four, we need system resilience so Canada remains an attractive environment for research, clinical trials and life sciences investment. Pharmaceutical sovereignty is not an abstract economic concept; it's about whether Canadians can stay healthy, participate fully in society and trust that the medicines we need will be there when we need them.

On behalf of millions of patients across Canada, thank you. We encourage you to keep patient access, equity and lived experience at the centre of this study.

[The Chair, Liberal, Sukh Dhaliwal]

Thank you, Ms. Steele. That's perfect timing.

Now we will go to Ms. Parmar for five minutes.

Please, go ahead.

[Sonia Parmar, Vice President, Government Relations and Regulatory Affairs, Canadian Health Food Association]

Thank you.

Good afternoon.

The Canadian Health Food Association represents over 1,000 companies, including members across the entire natural health product supply chain in Canada.

This study is about pharmaceutical sovereignty. At its core, it's about control over what is produced in Canada, what is regulated in Canada and what products Canadians actually use.

Natural health products are not a niche category. Over 80% of Canadians use them. Vitamins, minerals, probiotics and herbal products are part of how Canadians manage their health every day. They are not only widely used by Canadians but also integrated into the health care system. They're often used in hospitals and long-term care. For example, vitamin D and calcium are used in institutional and high-risk populations to reduce fracture risk, and probiotics are used in some settings to help prevent hospital-acquired infections. Natural health products are tools that are complementary to pharmaceuticals. They play an important role in preventative medicine, improving outcomes and reducing pressure on the health care system.

To illustrate their impact, we commissioned a cost-benefit analysis grounded in established frameworks. Approximately $2.3 billion in avoided costs over 25 years could be saved, rising to $3.9 billion when similar interventions across the health care system are included. These figures, while reflective of standard health economic modelling, are conservative, capturing only select interventions and defined cost components.

From a pharmaceutical sovereignty perspective, this directly affects system resilience and reliance on supply chains. A system that can prevent demand is more sustainable and less dependent on constrained pharmaceutical supply chains. Natural health products also represent a critical component of Canada's domestic manufacturing base. We have an established sector that formulates, manufactures, tests and distributes natural health products domestically. These are Canadian facilities, Canadian jobs and Canadian quality. Sovereignty is not just about access. It's about control over production and standards within our own borders.

Canada has already made a deliberate policy choice in how it regulates this space. For over 20 years, natural health products have been governed under a dedicated regulatory framework that reflects their lower risk and their role in prevention. The current framework was designed to rightsize regulation while maintaining oversight, but there is a growing risk to that system, and it goes directly against sovereignty. Under the Food and Drugs Act, Canadians can import a personal supply of health products, commonly understood as being for up to 90 days. In practice, this is being leveraged at a commercial scale by foreign companies to access the Canadian market without meeting Canadian regulatory requirements.

Let me put this another way. This is not always being used for personal use. This is a direct commercial pathway into Canada that bypasses Canadian regulatory oversight, creating risks for safety, fairness and system control. Our analysis estimates that this represents approximately $450 million per year, a substantial portion of the natural health product market operating outside Canadian regulatory oversight. That's nearly 10% of the Canadian market, which continues to grow. This activity may also be associated with an estimated $51 million in tax revenues lost annually that would otherwise support the Canadian economy and public services.

At home, the rules keep tightening even as red tape reduction is promised, leaving Canadian businesses to compete against a channel that operates outside of our rules. It's like asking one team to play by the rule book while the other team gets to decide its own rules. If requirements continue to tighten without closing that gap, consumption won't go down. It will keep moving outside the Canadian system, leaving Canada with less production, less control and less sovereignty.

The question before this committee is not whether natural health products should be regulated. They already are. The question is whether Canada keeps control of this part of the market or lets it move beyond our oversight. If we lose control of the lowest-risk, most widely used products in our system, we're not strengthening pharmaceutical sovereignty. We are surrendering it.

Thank you.

I look forward to your questions.

[The Chair, Liberal, Sukh Dhaliwal]

Thank you, Ms. Parmar. That's well done.

Now we will go to Mr. Lévesque.

Mr. Lévesque, you have five minutes. Please go ahead.

[Stéphane Lévesque, General Manager, Groupement provincial de l'industrie du médicament]

Mr. Chair, members of the committee, thank you for inviting me to contribute to this important study on Canada's pharmaceutical sovereignty.

My name is Stéphane Lévesque, and I am the general manager of Groupement provincial de l'industrie du médicament, or GPIM, an association that has been active for more than 40 years and represents small and medium-sized businesses and emerging pharmaceutical companies, primarily in the generic drug sector.

At the outset, we must recognize a fundamental reality: Pharmaceutical sovereignty is a complex and difficult objective to achieve. We must be realistic: Canadian pharmaceutical sovereignty will never be absolute. We must also recognize that it depends as much on provincial governments as on the federal government. Better collaboration among all levels of government will be essential if we truly want to make progress.

That said, we can certainly do better.

First, let's talk about Canadian ownership versus simply being established in Canada.

It is essential to distinguish between a pharmaceutical company merely operating in Canada and one that is Canadian-owned. Foreign companies established here play an important role, but Canadian-owned companies should occupy a more strategic place in our pharmaceutical autonomy. The pandemic demonstrated the limits of excessive dependence on foreign interests. Some countries prioritized their own populations by redirecting medicines, vaccines and medical equipment. Canada must therefore implement targeted financial, regulatory and commercial measures to better support Canadian-owned pharmaceutical companies.

Second, let's look at Health Canada delays.

In 2018, the modernization of regulatory fees was intended to improve regulatory performance. Today, however, we are witnessing the opposite. Review timelines for drug submissions continue to grow longer. Delays are now measured in months, sometimes years, even though the established target for a generic drug review is 180 days. Meanwhile, other jurisdictions, particularly the United States, are improving their efficiency. Without regulatory predictability, investments become significantly riskier.

Recently, to improve performance, Health Canada proposed an order allowing reliance on decisions or documents from foreign regulatory authorities for certain drugs. GPIM was the first organization to raise concerns that this measure could produce the opposite effect of what is intended. It could further overwhelm Health Canada's already limited internal resources due to an increasing number of submissions from foreign companies and could even lead to a form of regulatory dumping, to the detriment of Canadian-owned businesses. This is not encouraging for Canadian pharmaceutical sovereignty.

Third, let's consider the lowest-price policy for generic drugs.

Provincial reimbursement policies based almost exclusively on the lowest price represent a major obstacle to pharmaceutical sovereignty. Twenty or thirty years ago, a much larger share of medicines were manufactured in Canada. However, the combination of lowest-price policies and the absence of annual indexation pushes manufacturers toward lower-cost countries such as India and China. Without policy changes, this offshoring trend will continue.

Fourth, let's turn to buying Canadian.

GPIM supports a buy Canadian policy that includes pharmaceuticals. A portion of hospital procurement contracts and strategic stockpiles of essential medicines should be reserved for Canadian-owned companies.

Fifth, let's consider active pharmaceutical ingredient, or API, manufacturing.

We can have all the manufacturing capacity in the world in Canada, but without access to active molecules, we are heading in the wrong direction. We must support innovative and less-polluting API manufacturing. At Université de Montréal, Professor André Charette is working on continuous flow manufacturing, with the support of Médicament Québec. The project is an excellent example of this but has been slow to materialize due to insufficient government support.

Sixth, let's look at strategic alliances.

We must develop agreements with reliable and trusted countries in order to share certain production capacities. A chosen and strategic interdependence is preferable to a dependence imposed upon us.

In conclusion, pharmaceutical sovereignty will require consistent political choices, targeted investments and better coordination among governments. Above all, it will require a long-term vision aimed at protecting the health and economic security of Canadians.

Thank you.

[The Chair, Liberal, Sukh Dhaliwal]

Thank you very much. It was perfect timing.

Now we will go to the honourable members. We will start with Madam Konanz for six minutes. Please go ahead.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Thank you, Chair. My questions are for Ms. Parmar. Canada created a distinct regulatory framework for natural health products more than 20 years ago. Why was a separate framework necessary, and does it still serve an important purpose today?

[Sonia Parmar]

It is absolutely necessary for natural health products to be a distinct category. Previously, they were regulated as both foods and drugs, and this was not considered appropriate. This is a world-renowned regulatory framework that was put together, so for many reasons natural health products need to be “right-size, right-fit” regulated.

There are reasons, for example, that they are not patent protected. They are often combined with many ingredients, and they don't act the same way as pharmaceuticals do, or necessarily as foods do. They are closer to foods, so you will see that the whole framework itself needs to be regulated as distinct. We have seen over time that this has been lost more and more with the legislative and regulatory framework proposals that Health Canada has put forward, which is why we have been fighting that natural health products are not drugs and do need to be regulated appropriately according to their risk level.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Thank you for that answer. Are there other countries that we mirror ourselves after or that would be good to follow, which are doing this successfully?

[Sonia Parmar]

Canada has actually been the international standard for about 20 years. It wasn't until the legislative and regulatory proposals were put forward that IADSA—the international dietary supplement association, so the NHP association of associations globally—actually came out and said that all of the regulatory and legislative proposals that have been put forward have weakened our system, such that if we go too far or we regulate something too much, it no longer fits its purpose. Therefore, Canadians can lose access.

Over-regulation is very serious for our industry. It is something that needs to be taken seriously, because, as I mentioned, we are in direct competition with other countries like the States, which have a much easier pathway to market. Canada is the only country that has a rigid premarket approval system, so when we're in direct competition with countries like that, it makes it very difficult for Canadian companies to compete. We would like to remain number one in the world, in which case we really need to make sure that our regulations are fit for purpose.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

I believe you referenced, in your opening statement, a growing amount of market activity occurring outside Canadian regulatory oversight. In your view, what needs to happen to close that gap, while ensuring that Canadian businesses can remain competitive?

[Sonia Parmar]

A couple of things need to happen. Health Canada has to help close the gap. In other words, Canada needs to do a better job of making sure that our borders are secure when things are coming in. Canada Border Services Agency, Health Canada and the RCMP are groups that need to work together to ensure that Canadians aren't necessarily exposed to the amount of illegal product or product outside the Canadian regulatory framework.

Health Canada also needs to recognize that these businesses need to be able to compete, and, therefore, the regulatory system itself needs to be an appropriate and right fit for the risk-based profile that these products present.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

There's $450 million in market activity that occurs outside Canadian regulatory oversight. What impact does that have on Canadian manufacturers and retailers and on investment in domestic production?

[Sonia Parmar]

It has a great impact. You'll see that often retailers will tell you experiences of Canadians coming in on their mobile phones with products that they can access quite easily from the States or other countries—namely, the States—that they can't necessarily find in Canada. It greatly diminishes sales at the retail level. It has a much bigger picture and impact when you look at manufacturing. It goes throughout the ecosystem. It greatly diminishes access.

As I said earlier, Canadians aren't necessarily going to stop consuming. They will find other ways and, in many cases, less expensive ways to buy products, so it shuts down from manufacturing all the way through the supply chain and impacts at the retail level. It also has an impact on Canadians when they're potentially reaching out for riskier products or those that are not within the Canadian regulated system.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Is Health Canada aware of the growing amount of market activity occurring outside the Canadian regulatory system, and what is being done about it? We don't have a lot of time, but I imagine that's a loaded question.

[Sonia Parmar]

We've made Health Canada aware. They are working with us to some degree, but more can definitely be done. They have, just this morning, put out a public advisory to notify Canadians of the work that they've done with Operation Pangea, but I would say that, in the past, they've also told us that Canadians need to have access in the ways that they choose, which is why we have said that includes from our domestic Canadian supply chain.

Many unintended consequences can happen when we don't close that gap, and Health Canada is aware. We have made formal complaints about this. We are hoping that they step up to the plate and really close down some of these channels, especially some of the larger players that we have made them aware of.

[The Chair, Liberal, Sukh Dhaliwal]

Thank you.

We will go to Mr. Rana for six minutes.

Please, go ahead.

[Aslam Rana, Liberal, Hamilton Centre, ON]

Thank you, Mr. Chair.

Thank you to all the witnesses for spending your valuable time with us this afternoon.

Ms. Kim Steele, back in March 2026 this committee heard from various experts that Canadian pharmaceutical sovereignty does not mean making everything in Canada. Instead, it implies a precedent-based national strategy that reduces overreliance on global sources.

Could you please tell this committee if there are any over-dependencies on internationally supplied pharmaceuticals in Canada?

[Kim Steele]

I would say that what we see is supply that we need, and we don't often get supply that we do need. I can't say that we're overrepresented, but I can say that there are still people who can't get the medicines they need.

At the end of the day, our role as a country is to ensure that our people can get medicines. If we can't get them into Canada and we can't produce them in Canada, we have to figure out ways to do that.

[Aslam Rana, Liberal, Hamilton Centre, ON]

How can Canada diversify our pharmaceutical supply chain to avoid over-dependencies and ensure that Canadians get the help they need?

[Kim Steele]

I'm sorry, I didn't hear the lead of your question.

[Aslam Rana, Liberal, Hamilton Centre, ON]

How can Canada diversify our pharmaceutical supply chain to avoid over-dependencies and ensure that Canadians get the help they need?

[Kim Steele]

Again, our brief is really largely on patient access. I am not a supply chain expert. However, I think we have lots of people who have testified before this committee who have had some very good ideas in that area.

At the end of the day, there are medicines that we can make in Canada, but there may be medicines that we can't. To get a supply chain in order that makes sure that the medicines that come through to Canada are coming through on time, they are not in shortage, there are no delays and that they continue to come to Canada, that companies don't decide to not bring them to Canada.... Those are all significant issues. The supply chain is just one part of that overall access issue.

[Aslam Rana, Liberal, Hamilton Centre, ON]

This committee has heard that there are issues with monitoring the drugs available in the country at given times. There are also calls for data sharing across the country on medication availability and stockpiles. Should the federal government require faster real-time reporting on inventory levels, shortages and supply chain risks?