Mr. Speaker, I move that the 14th report of the Standing Committee on Health, presented on Monday, June 6, be concurred in.
It is a pleasure to ask the House to concur in a report on an issue that was debated in the committee for some time. We worked on this periodically throughout the winter. It was delayed at some points along the way because of other legislation but it is a very important issue.
As far back as November last year the minister suggested in public that this issue was his top priority and that he would act on it in a significant way as soon as he possibly could and yet we have seen nothing.
What has been amazing is that we have seen the minister throw a ball in the air almost on a weekly basis to see who will shoot at it waiting for some of the repercussions around the Internet pharmacy issue. However we see absolutely no action and we are seeing more and more delays.
The report deals with how we handle the issue appropriately. The issue of Internet pharmacies has become a significant one and the report calls for legislation to be adopted that would not allow bulk sales of pharmaceuticals to be exported from Canada into the United States.
There is a very good reason for that. One has to understand how the Internet pharmacy industry actually came into being, why it is there, how it is supported and under what mechanisms it is supported under law. First, in the United States there is a law against it. It is not legal to import pharmaceuticals into the United States but there is not a congressman, senator or politician in the United States who would stand up and say that gramma should pay twice as much for her pharmaceuticals as she is now paying. It becomes a political football and political issue more than anything else and that is why we are seeing some resistance for the United States to actually enforce the law that it has on its books.
Instead of that, we have seen the Internet pharmacy come into being about five years ago and start to progress in terms of the numbers. The intensity and the size of the industry has exploded over that time period to the point where we have sales figures of perhaps a little bit more than $1 billion a year, although no one is exactly sure of the amount. We actually saw signs over the last year where it has subsided somewhat. The last numbers I have show a decrease of about 10% over the last year.
How come it is there? Why did it come into being? Why would we sell pharmaceuticals from Canada into the United States? I think it is important to understand how the industry is fuelled. It came into being about five years ago. It is not for all pharmaceuticals. It is more for the brand name pharmaceuticals. Brand name pharmaceuticals in Canada are dealt with under the price market review board which decides how to set the price of pharmaceuticals. It takes the medium of seven different corporations and then it sets that as a price, so it is a regulated price in Canada.
A regulated price, by the way, is quite a bit different from what we have with our counterparts in the United States. In fact, it is somewhere between 30% or 40% cheaper than it is in the United States.
The Patented Medicine Prices Review Board has actually done a very good job for Canadians. It has supported lower prices for brand name pharmaceuticals in Canada and has been working very well over the last number of years affording Canadians a cheaper price for their pharmaceuticals.
There is another thing that is at play that we have to understand and that is the differential in the price between the Canadian dollar and the U.S. dollar, so the buying power for the U.S. dollar coming up to Canada also makes a significant difference in the buying power for those pharmaceuticals.
We can see that when the prices are artificially set lower in Canada compared to the United States, which has a free market on patent medicines, there is an industry that really is exploiting the difference between those two regimes on the pricing of brand name pharmaceuticals.
All pharmaceuticals are becoming increasingly used by our populations. I would suggest that the number one driver of costs of our medicare system in Canada and in the United States is the cost of pharmaceuticals. That is not going to go away fast. In fact, if we are looking for relief with regard to the Internet pharmacy or brand name pharmaceuticals being used in our society I think we are fooling ourselves. There is no one who would project that. As the baby boomer bubble hits our system they will be feeling their aches and pains much more as they age.
Our population has become quite dependent on pharmaceuticals. I am not against pharmaceuticals in any way. They have advanced the ability of Canadians to have relief from pain for a significant amount of time. In these last few decades we have seen some tremendous advancements in how we use pharmaceuticals and in the relief we have received.
I am not against pharmaceuticals but I am throwing some flags in the air because we have some problems with pharmaceuticals in Canada. In a study that came out last June, pharmaceuticals used in acute care centres were shown to be the cause of approximately 24,000 deaths per year from adverse events and mostly preventable adverse events. That is like a Boeing jet going down every week in Canada.
Unfortunately, this House has really not been too aware of the situation, which alarms me when the report proving this to be the case came out last June. However we have had few repercussions in the House or in society with regard to the problem. This is not only a problem that has been around for a significant amount of time but it is one that will only get worse if we do not address it.
Pharmaceuticals need to be used but they need to be used in appropriate ways. How we can do that and actually protect pharmaceuticals in Canada is another issue, which is the issue addressed in this committee report.
The issue was not studied intensely in committee but reference has been made to it over the last couple of years as we travelled across Canada. Last year it came up in Manitoba which is where Internet pharmacies started and where the bulk of Canada's Internet pharmacies sit. They employ over 5,000 individuals in Canada. However these Internet pharmacies are not just in Manitoba. They have expanded into British Columbia, Alberta and, to a lesser degree, into other provinces across Canada. It is a Canadian industry and it is a Canadian issue.
What we have seen over the last year is an expansion of Internet pharmacies to where they are being used more and more and, in fact, have exploded. It went from an industry with an estimated $400 million in sales in 2003 to over $1 billion in sales last year. When we see such a significant growth in an industry like this, it sets off all kinds of alarm bells.
However that is not really why this motion is in the House and it is not why the committee unanimously said that we should be bringing this forward. It is coming forward because of what is happening south of the border. In the United States, the senate and the congress have two or more pieces of legislation to change U.S. laws and allow Canadian drugs to legally enter the U.S., not just from the Internet pharmacy to the individual but to allow bulk sales.
We have a significant number of states in the U.S. starting to change their laws. In the last report I saw that 25 states were changing their laws or already had laws on the books to allow bulk sales of pharmaceuticals to be bought from Canada. Ten of those states have actually had that legislation passed and have them on the books at the present time.
Why the urgency? It is because we are seeing this push for the changing of laws in the United States.
Pharmaceutical companies are starting to kick back and we are seeing advertisements in the United States at the present time saying that drugs from Canada are very dangerous and that no one can be sure the drugs are really from Canada. These drugs could be from India or even from China. In fact, most of our pharmaceuticals are not really manufactured in Canada. They are imported from other places.
The controls on some of the brand name pharmaceuticals are coming from places where they do not meet the same kinds of tests nor the same kinds of standards that we have in Canada.
I see no evidence of that, and it is refuted by the Internet pharmacy people, but I think it would be fair to say that most of the drugs that are manufactured in the United States and come into Canada fall under our the prices review board. The board then significantly lowers the prices on these drugs for Canadians and then they are imported back into the United States. The pharmaceutical companies are saying that is unfair. Why would they bring their pharmaceuticals into a foreign country, have them fall under a review board just to have them come back into their country and destroy the market forces that are at play in a foreign country?
As members and as Canadians our first goal should not be looking after Americans. Our first goal should be looking after Canadians. We should respect both the availability of these products and the price of these products. If either of these is compromised then this House has to act. We should act swiftly, not sitting around throwing balls in the air and expecting that something will change or something will happen.
A while back the committee told the minister not to act on the issue until it had some indication of where it was at on the matter. The committee held meetings with both sides on the issue in an attempt to understand the dynamics of the situation. There were some significant reasons for the industry being there and some very good arguments as to why it should not be destroyed.
We have three choices. First, we could very easily kill the industry by just shutting it down. What would the repercussions be of destroying the industry? First, we would destroy all the jobs and all the opportunities for those jobs in Canada. I also do not believe it would be in the best interests of the United States. Right now most of these pharmaceuticals go to individuals in the United States who are outside of a health program or a pharmaceutical program in the United States. These are the people who cannot afford the drugs and who will not be buying the drugs at any rate from the United States because they cannot afford them.
We are supplying that relief valve to the market in the United States through the Internet. That is not a bad thing. In fact, the pharmaceutical companies are saying that they can live with that.
It is when we get into the bulk sales. This is where this industry is about to grow that it becomes a significant problem.
We could kill it but I do not think that would be productive. I do not think it would necessarily be fair for a free enterprise market which exists in Canada and the United States. I also do not believe that would be in the best interest of anyone.
Our second option is to leave it the way it is. However, if we do leave it the way it is we could see the situation explode over the next decade. We will see the numbers increasing as the laws in the U.S. change to allow these products into the United States, not only to individuals but also to states, in bulk lots. We could be looking at the situation exploding not just to a billion dollars a year, but to many billions of dollars a year. Therefore, it would destroy the industry.
This would have an impact. It would have an impact on our price market review board because it would no longer be able to control the industry. The pharmaceutical companies would say that it was foul play and they would be legitimate in saying that. Then they could say that they will not supply the Canadian market. Why would they when we are exploiting the market review in Canada and apply this rule to a foreign country.
Therefore I think the pharmaceutical companies would be quite legitimate in saying that it was not appropriate, but to leave it just the way it is, is not an option. We need to act and we need to act on behalf of Canadians because of supply and because of price.
We would either compromise the price and see the price jump or we compromise the supply and see availability drop. One of the two would happen if we were to leave it the way it is. Therefore that is not an option.
The third option would be to control it by trying to contain the industry. We could allow it to continue supplying jobs to Canadians and that relief valve to Americans but we must not allow it to grow to the place where it becomes prohibitive or an irritant and a threat to our availability and our price.
How we contain the situation becomes the magic of this argument and the magic of this whole industry. How in this House can we come together and do what is not necessarily political, whether we are a Conservative, a Liberal, an NDP or from the Bloc, but something that is in the best interest of all Canadians, which is to protect our pricing and our availability of products?
As I have said, as we move forward into the next decade of the 21st century we are going to use pharmaceuticals more than we ever have before. In fact, that is one of the problems we have. As a society, we have become so accustomed to using a pill every time we have a sore ankle, a sore knee or a problem of any kind that the first thing we say is “there is medication for that”.
We have become a society that is dependent on this, so much so that we believe there is a pill for every problem we have. The first thing we look for in our health care system is how we fix our problem with medication. Until we become a society which also understands that every pill has a problem, we are not going to have a fair balance and enough knowledge to understand how to use those medications appropriately.
At present, whether we look at the June study I mentioned earlier, on the 24,000 deaths per year in Canada, or at the abuses in our seniors' homes and the intensity and the amount of pharmaceuticals used there and the deaths being caused because of addiction to these medications, we are not going to be able to move forward in our health care system in the way that we should for Canadians.
Addiction to pharmaceuticals is, as I say, the other side of this. I introduced a private member's bill last session calling for any adverse events to be reported to Canadians so that we have an understanding of who is addicted and what kinds of adverse events are being created. Then we could actually deal with them. I think these are important things to look at when we see the number of deaths that are being caused because of this.
I want to close by imploring the House to consider the motion. As I have said, it comes from the health committee and has significant support. I say that because when we talked to the Internet pharmacy people, they agreed with the motion. They are saying to not let us get into bulk selling of pharmaceuticals. They are saying to stay out of it, that we do not need to go there. They say they just want to keep on with the business they have at the size they are at the present time.
They are calling for this. They are saying that this is a good move. The brand name pharmaceuticals are also saying that this is a very good move, that we need this to be able to stop the explosion of what could happen with the legislation coming in the United States.
No one on either side of the issue is saying that this is a bad motion. They are saying that it may not be totally satisfactory and it may not go far enough for some of the brand name pharmaceuticals, but so far everyone is saying that as far as shutting down bulk sales into the United States is concerned it is the way we should go.
Here is what I would say to the minister. Instead of throwing balloons into the air and trying to take his cue from the Prime Minister, who dithers on everything, as we have seen since he has come into office, instead of being Mr. Dithers too, the health minister should say, “Let us have some leadership and let us actually do something that is in the best interests of Canadians and the Canadian pharmaceutical industry”. And that is to shut down bulk sales of pharmaceuticals.
I know this rubs my colleagues on the other side the wrong way, but the truth is the truth and that is exactly what I am saying with regard to a health minister who said last November that this was his number one priority and he was going to fix the system. We have seen absolutely nothing to this point.
Let us get serious about fixing the problem, we say, and let those of us in this House take a look at this motion. I dare anyone to stand on the other side and say no, this is something we should not do. We should do this. We should do it now. We should give a directive to the health minister that this is where we need to go, because he does not seem to be able to get off the fence on this one.
Every colleague in the House should consider this motion in a serious way. That is why we have brought it here: to have the House concur with what the health committee has already agreed to. I implore everyone to consider this motion in a very serious way, because it is the right thing to do for Canadians, it is the right thing to do in the House and it is our obligation. Let us get it done and get it done today.