House of Commons Hansard #165 of the 39th Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was drug.


Budget Implementation Act, 2007Government Orders

5:25 p.m.


The Acting Speaker Conservative Andrew Scheer

I think right now we are at 5:30 p.m. I would ask the hon. member for Mississauga South to raise his point of order after the deferred recorded division is taken.

The House resumed from May 11 consideration of the motion.

Citizenship and ImmigrationCommittees of the HouseRoutine Proceedings

5:25 p.m.


The Acting Speaker Conservative Andrew Scheer

It being 5:30 p.m. pursuant to order to made on Thursday, May 31, 2007, the House will now proceed to the taking of the deferred recorded division on the motion to concur in the fourth report of the Standing Committee on Citizenship and Immigration in the name of the hon. member for Trinity—Spadina.

Call in the members.

(The House divided on the motion, which was agreed to on the following division:)

Vote #197

Committees of the HouseRoutine Proceedings

6 p.m.


The Acting Speaker Conservative Andrew Scheer

I declare the motion carried.

The House resumed from May 31 consideration of the motion that Bill C-298, An Act to add perfluorooctane sulfonate (PFOS) and its salts to the Virtual Elimination List under the Canadian Environmental Protection Act, 1999, as reported (with amendments) from the committee, be concurred in.

Perfluorooctane Sulfonate Virtual Elimination ActPrivate Members' Business

6 p.m.


The Acting Speaker Conservative Andrew Scheer

The House will now proceed to the taking of the deferred recorded division on the motion at report stage of Bill C-298, under private members' business.

(The House divided on the motion, which was agreed to on the following division:)

Vote #198

Perfluorooctane Sulfonate Virtual Elimination ActPrivate Members' Business

6:10 p.m.


The Acting Speaker Conservative Andrew Scheer

I declare the motion carried.

It being 6:14 p.m. the House will now proceed to the consideration of private members' business as listed on today's order paper.

Order, please. I see a number of hon. members engaged in conversations on the floor of the House. It will be difficult to proceed to private members' business unless we get a little of order. I would invite the hon. members, if they need to carry on conversations with their colleagues or with ministers, to do so outside the chamber.

Food and Drugs ActPrivate Members' Business

6:15 p.m.


Carolyn Bennett Liberal St. Paul's, ON

moved that Bill C-378, An Act to amend the Food and Drugs Act and the Food and Drug Regulations (drug export restrictions), be read the second time and referred to a committee.

Mr. Speaker, I am pleased to have the opportunity tonight to discuss with my colleagues from all parties Bill C-378, An Act to amend the Food and Drugs Act and the Food and Drug Regulations (drug export restrictions).

My bill is aimed at controlling the cross-border trade in prescription drugs and vaccines. The bill would amend the Food and Drugs Act to prohibit the export of drugs set out in schedules D and F to the Food and Drug Regulations, Vaccines and Prescription Drugs, except as permitted under the regulations.

The bill would make it an offence under the Food and Drugs Act to export prescription drugs in prohibited circumstances. By amending the Food and Drugs Act, the legislation will protect Canadians.

My bill is constructed to protect the Canadian pharmaceutical supply from being bulk exported south of the border. There is such a large price differential between American and Canadian pharmaceutical prices that there is great pressure on the U.S. at this time to import cheaper drugs from Canada.

With over 35 million members, AARP is the leading non-profit, non-partisan membership organization for people age 50 and over in the United States. It wields an enormous amount of power and is at this time launching a very major communication initiative.

However, during my meeting with the organization in Washington during the break week, it was clear that its real intention was not to import pills from Canada, but to import prices from Canada and to make Americans very angry that they were paying too much for brand name prescription drugs.

Let me put it plainly. Canada cannot become America's discount drug store. Canada needs to protect itself from dramatic expansion of importation by the U.S. of drugs intended for our patients. The prospect of the U.S. legalizing large scale purchases from our domestic supply is real.

The threat to Canada's drug supply increased on January 10, after some U.S. politicians stepped up their efforts to facilitate bulk imports of prescription drugs from Canada with the introduction of the pharmaceutical market access and drug safety act of 2007. The legislation was introduced by Senators Dorgan and Snowe and Representatives Emanuel and Emerson, who are co-sponsoring the companion house legislation.

The legislation, which has the backing of key U.S. Democrats and Republicans, would allow individuals to directly order medications from outside the U.S. It would also allow U.S. licensed pharmacists and wholesalers to import FDA approved medications from a number of countries, including Canada.

In May senators both approved the measure and then voted to require U.S. health authorities to certify drug imports were safe. Since the U.S. federal drug administration has already made it clear that it will not provide certification, the bill was dead on arrival. The House of Representatives is set to debate a similar measure soon, but few expect things to change.

However, Representative Emerson has stated that she is committed to finding a way to make this legislation happen. Because it is unlikely the legislation will get through the house and energy committee, we believe she is looking to attach drug importation to another bill. Furthermore, dozens of U.S. jurisdictions at state and local levels continue to introduce measures designed to help local citizens, government employees, retirees and others buy Canadian drugs.

Any of these measures pose an imminent and serious threat to the security and integrity of Canada's drug supply, and a genuine threat to the health of Canadians. It may have been good short-term politics, but it is terrible long term policy.

American seniors are rightfully outraged by the high prices of pharmaceuticals in their country, but outsourcing price controls is not a responsible approach.

In Canada we have addressed price control with the Patented Medicine Prices Review Board, which regulates drug prices to ensure that the prices of patent protected brand name drugs are not excessive. Canada has regulated drug prices for the past 15 years.

The United States does not have a similar control mechanism, and the problem is exacerbated by U.S. drug companies spending millions of dollars every year to defend their higher prices. Every year, U.S. drug companies spend hundreds of millions of dollars on political influence, including lobbying, campaign donations and extensive ad campaigns to defend their high prices and fight against price control. The American drug industry employs over 600 lobbyists in Washington alone, more than one for every member of congress. This system drives U.S. prices even higher.

Another important difference between the Canadian and American system is the regulation of advertising.

Prescription drug advertising is one of the most controversial practices in the American pharmaceutical industry. During the first nine months of 2002, American pharmaceutical companies spent over $16 billion promoting their products to physicians and consumers. This kind of advertising drives prices up and is prohibited in nearly all other western countries.

In Canada, the Therapeutic Products Directorate strictly regulates prescription drug advertising.

I would also like to discuss how drug importation legislation represents a threat to American patients by allowing relinquishment of necessary community based medication monitoring and management at increasing risk from potential counterfeit drugs.

The incidence of counterfeit medicines is small but is growing in developed nations. The recent tragic death of a British Columbia resident, determined by a coroner to have been caused by counterfeit medicines in her possession, serves as a reminder that North America is not immune from the global phenomenon.

The counterfeiting of medicines is an issue that threatens the quality and integrity of Canada's drug supply, a problem that will be greatly exacerbated if U.S. drug importation legislation is passed into law without a clear and effective Canadian prohibition on bulk drug exportation.

I was pleased to see the public safety committee's report entitled “Counterfeit Goods in Canada — A Threat to Public Safety” which included this recommendation:

--the Government of Canada institute a campaign to raise awareness of counterfeit and pirated goods to make the public aware of the economic and social costs associated with this scourge, and emphasize the public health and safety hazards they represent. The campaign should also raise Canadians' awareness of the involvement of organized crime in the counterfeiting and piracy of goods.

Internationally the WHO is very concerned about counterfeit drugs. The WHO has struck the International Medical Products Anti-Counterfeiting Taskforce, tasked with increasing international collaboration to combat counterfeiting.

I would also like to point out that allowing bulk prescription drug imports would not significantly reduce U.S. prescription prices for very long. Even a recent University of Texas study concluded that based on the worst case scenario, Canada's stocks of prescription drugs would amount to about a 38 day supply for the United States, assuming all U.S. medications were Canadian sourced. Once U.S. demand depletes Canadian stocks, prices will almost certainly rise, narrowing or even possibly eliminating the difference between U.S. and Canadian pharmaceutical prices.

Some may argue that Canada should just increase manufacturing of pharmaceuticals to meet U.S. demand.

However, Canada's innovation-focused pharmaceutical industry develops, manufactures and distributes drugs designed to meet the needs of Canadian patients and the Canadian market. It bases its production on the size of the population and the incidence of the illness or condition to be treated.

Manufacturers produce sufficient prescription drugs to meet the expected national demand. Consequently, if one country imports its prescription drugs from another, it diminishes the exporting country's stock of drugs to meet the expected needs of patients in that country.

Labelling regulations also differ from country to country. As a result, prescription drugs produced for the American or South American markets cannot just be sent to Canada to meet an unexpected need.

Given the complexity of calculating annual estimates of the needs of Canadian patients, together with the detailed methods used by drug companies to manage their inventory and respond to patients' needs, it is unrealistic to think that products manufactured for Canada could meet American demand.

Cross-border trade is not only detrimental from a public policy perspective, it is also virtually impossible to do.

I would like to underline again that Canada cannot meet the prescription drug needs of approximately 280 million Americans without putting our own supply at risk.

Take for example the events of the fall of 2005. In November 2005 when Roche Canada took the unprecedented step of suspending sales of Tamiflu to the Canadian market, there were reports that Internet pharmacies were busily filling foreign prescriptions at a significant profit. One B.C. pharmacy alone was reportedly filling 400 orders a day from the U.S. That is a significant number when according to the Canadian Pharmacists Association only 4,000 Canadians received the drug that September. Another Internet pharmacy in Montreal issued news releases promoting to U.S. customers its Tamiflu stocks.

The Canadian Pharmacists Association reacted to the Tamiflu incident by saying that the government should have acted to protect the country's supply of the drug. Again, when supply gets siphoned off to the U.S., it is Canadians who come up short.

This situation is a perfect example of the types of scenarios Canadian patients will face if Canadian governments continue to allow drugs to be diverted to the U.S.

This is not an issue unique to North America. In April of this year the European Union passed resolution 31 stating:

Is concerned about the intention of the US Congress to authorise parallel imports of medicines from the EU Member States, that may create obstacles to the EU patients' supply and favour counterfeiting of medicines; asks the EU, therefore, to raise this issue at the forthcoming Summit--

I would also like to take the opportunity to commend my colleague, the member for Vancouver South who in 2005 when he was health minister anticipated this problem and put forward legislation, Bill C-28 to consensus in the House. Unfortunately, an election was called before the bill went forward.

Current Canadian policy is to use only reactive measures and seek to manage shortages once they have already occurred. This is not enough and it may well be too late.

The issue of bulk exports to other countries of medicines and vaccines destined to Canadians should be an issue of concern to all of us. It is of particular interest to the Canadian Pharmacists Association and the Ontario Pharmacists Association.

I believe the passage of Bill C-378 is essential to protect the supply and integrity of prescription drugs here in Canada and will send a strong message to our American colleagues of the futility of their short-sighted legislative initiative.

I urge all colleagues to support my private member's bill, Bill C-378.

Food and Drugs ActPrivate Members' Business

6:25 p.m.


Dave Batters Conservative Palliser, SK

Mr. Speaker, I listened to the member for St. Paul's with great interest.

First of all I would like to take this opportunity to commend her on this effort. I know she has put a lot of work into this private member's bill.

I was shocked to hear in her remarks just how quickly the Canadian drug supply could be depleted if we were to continue to allow bulk exports of pharmaceuticals to the United States. In particular, if the situation were to change in the United States and the Americans were to allow for bulk importation, our drug supply that we need for Canadian seniors and youth, people from coast to coast to coast, could be depleted in as little as 38 days by our huge neighbour, the elephant living to the south of us, the United States.

Bill C-378 is trying to be proactive and take measures to stop our supply from being depleted before it ever happens, to protect the Canadian drug supply.

If the government is not proactive and reacts, if legislation changes in the United States and allows for bulk importation, what tools does the government have at its disposal to react? How quickly could the government act and make those changes? We realize we would not have much time. We would have 38 days until our entire supply was depleted. What tools does the government have and how quickly could the government respond in a crisis situation like that?

Food and Drugs ActPrivate Members' Business

6:30 p.m.


Carolyn Bennett Liberal St. Paul's, ON

Mr. Speaker, that is an excellent question. It is one which, when we were in government, we were concerned about in terms of the need to immediately protect a drug like Tamiflu when we see hoarding and those kinds of things that happen. It is the reason that seniors organizations have been very supportive of this bill and the previous Liberal government's bill.

The Minister of Health believes that through regulation he might be able to act. We feel that is not strong enough. There needs to be an explicit change to the act and therefore the regulations so that overnight the minister could actually exercise his will in being able to protect one specific drug, as the member said, if there was a big sucking sound of all of the drugs from Canada going south, and probably he would have more--

Food and Drugs ActPrivate Members' Business

6:30 p.m.


The Acting Speaker Conservative Andrew Scheer

Questions and comments, the hon. Parliamentary Secretary to the Minister of Health.

Food and Drugs ActPrivate Members' Business

6:30 p.m.

Charleswood—St. James—Assiniboia Manitoba


Steven Fletcher ConservativeParliamentary Secretary to the Minister of Health

Mr. Speaker, I have two questions for the member.

It is a little ironic that the member has brought forward this bill because not so long ago the Liberals were in the power and they had the opportunity to do so. The Internet pharmacy industry actually reached its peak in 2004 at sales of $850 million per year. Last year the total annual sales were $211 million. There was a very sharp decline in the fourth quarter to 75% below its peak under the Liberal regime. It is reasonable to assume that when the next statistics come out, there will be an even further decline because of the sharp appreciation of the Canadian dollar. That is one area.

My other question deals with the fact that when the amendment was put forward in the United States there was a provision stating that no imports would be allowed unless the Secretary of State--

Food and Drugs ActPrivate Members' Business

6:30 p.m.


The Acting Speaker Conservative Andrew Scheer

I hate to cut off the hon. parliamentary secretary but I have to allow the hon. member for St. Paul's to respond.

There are only about 30 seconds left, so we will go to the hon. member for St. Paul's.

Food and Drugs ActPrivate Members' Business

6:30 p.m.


Carolyn Bennett Liberal St. Paul's, ON

Mr. Speaker, dealing with the first question, this bill is about bulk imports. The statistics the member was referring to are individual Internet sales. Those are going down, I hope, because of public education about the risk patients are putting themselves in by taking drugs that they have ordered over the Internet which may well be counterfeit.

We have a huge problem also with Internet pharmacies putting Canadian flags on the drugs and they are not actually Canadian companies. That is being lost in the data that is being collected. It is a very good sign that the Internet sales to individuals are going down.

I would also advise the member that this week in Quebec four physicians were disciplined by the College of Physicians and Surgeons. This idea that Canadian physicians would be paid $5 or $50 to co-sign a script is just bad medicine and an unethical practice.

Those two--

Food and Drugs ActPrivate Members' Business

6:35 p.m.


The Acting Speaker Conservative Andrew Scheer

Order. We have run out of time. Perhaps the hon. members could have a conversation afterward about this point.

We will resume debate with the hon. Parliamentary Secretary to the Minister of Health.

Food and Drugs ActPrivate Members' Business

6:35 p.m.

Charleswood—St. James—Assiniboia Manitoba


Steven Fletcher ConservativeParliamentary Secretary to the Minister of Health

Mr. Speaker, I am pleased to speak to this private member's bill. This is a very serious issue and the government takes the issue of security of supply of prescription drugs and the protection of the health of Canadians very seriously.

When, in late October, the member for St. Paul's introduced the bill, she mentioned concerns about the effect of the then recent and potentially future U.S. initiatives aimed at facilitating cross-border drug sales to the United States. These two initiatives were restricted to individual purchases rather than wholesale or bulk shipments.

As I will outline further, we have not seen any impact from these initiatives. In fact, total sales to the United States have declined.

The member referred specifically to a U.S. measure to allow Americans visiting Canada to return with up to a 90 day supply of prescription drugs for their own use. In other words, this provision affected personal physical imports only, so-called foot traffic.

Although the measure became law on October 4, 2006, it essentially endorsed the then current U.S. administration practice regarding personal imports.

Members should know that the value of foot traffic purchases of prescription drugs in Canada has remained constant in recent years.

There was another U.S. development last fall, also in October, but not specifically referred to by the member at that time.

The U.S. Customs and Border Protection Agency ended its approximately one year practice of selectively seizing individual prescription drug purchases sent by mail from Internet pharmacies in Canada. While such personal mail order imports continue to contravene U.S. law, they have been tolerated, enabling the Internet pharmacy business in the first place.

As with the measures for foot traffic, we have not noticed any increase in sales associated with this U.S. Customs decision. In fact, the latest information from Health Canada shows that Internet pharmacy sales to the U.S. dropped by an additional 20% in the last quarter of 2006, resulting in total 2006 annual sales of $211 million.

The overall sales have dropped by 75% from their peak of $850 million in 2004. Why the decline? Several factors are at play. These include: the introduction of the U.S. medicare act part D, which, for the first time, provides drug benefit coverage for millions of previously uninsured or underinsured seniors; actions by manufacturers to restrict the supply of drugs sold to Canadian pharmacies involved in cross-border drug sales; the higher Canadian dollar; and, U.S. residents pursuing imports from other countries have also contributed.

When Bill C-378 was introduced last October, the government's assessment of the situation was that the U.S. initiatives with respect to foot traffic and mail order seizures did not pose a threat to the Canadian drug supply. This assessment has been proven valid. In the case of foot traffic, that is because sales predate Internet commerce and have existed for about 20 years. They have never posed a concern with respect to Canada's drug supply and the volume of such sales has been stable in recent years at an estimated $500 million.

The halting by U.S. customs of selective seizures of drug imports did not really change anything either as such personal imports have already been tolerated for a number of years anyway.

The most recent statistics bear this out. Foot traffic remains stable and Internet pharmacy sales dropped by 50% in 2006 and likely have dropped significantly more due to the sharp appreciation of the Canadian dollar since the more recent statistics.

Over the past several years, officials with Health Canada and the Department of Foreign Affairs and International Trade have continuously monitored the value of cross-border drug sales to the United States and related developments in that country, including the U.S. measures in October. Let me assure the House that they will continue to do so.

In the meantime, the Americans face ongoing challenges posed by the world's highest priced prescription drugs, explaining their continued preoccupation with finding way to make drugs more affordable. That is why the idea of importing lower priced drugs from Canada and other countries continues to be a political issue in the United States.

Federal legislators and state and municipal governments continue to see imports as part of the solution. Individual Americans, especially those without drug coverage, are also looking to other countries for relief from high drug prices.

At the federal level, in previous sittings of the U.S. Congress, a number of bills have been proposed to legalize drug imports, including bulk imports, from Canada. These legislative proposals were not able to gain a lot of support or traction, primarily due to the Republican majority in Congress and opposition by the U.S. administration. This was the case despite the fact that some bills were sponsored by Republicans.

However, I should point out that while some individual Republicans have supported and even sponsored drug import legislation, the official Republican Party position remains steadfast in opposing drug imports and in accepting high U.S. prices.

As the members in this place know, the U.S. legislative environment has been affected somewhat by the Democratic win in both houses of Congress last November. In this context, it is important to note that legalizing drug importations from Canada and other countries has reportedly been among the legislative priorities for some leading Democrats.

As I just noted, some Republicans have supported drug importation. In January of this year, a bipartisan group of U.S. Congress and Senate lawmakers introduced a bill that would allow importation from other countries. The pharmaceutical market access and drug safety act of 2007 would legalize both bulk or wholesale, as well as individual retail imports, including transactions via Internet pharmacies.

A democratically controlled Congress does suggest a greater potential for U.S. legalization of bulk imports. However, the overall view of Congress is that the prospects of enactment of legislation giving a clear green light to drug imports is dim at best.

To illustrate the point, let us look at developments in the last few months. In the U.S., opposition to the legalization of drug imports remains strong in many quarters. The enactment of legislation to legalize drug imports, without provisions for major impediments to such imports, is unlikely. This is especially the case given the Bush administration's opposition to drug importation.

There is potential for legislative horse-trading after such a controversial bill is introduced in the U.S. Congress. The U.S. Senators “endorsed” drug importation in early May, but included a provision--and this is very important--to disallow such imports unless the Secretary of Health and Human Services first certifies that they “pose no additional risk to the public's health and safety”, and that they will significantly reduce costs to consumers.

Proponents of importation have labelled this amendment as a poison pill, and with good reason. All observers agree, including the bill's lead sponsor, Senator Dorgan, that it has effectively neutralized the bill's drug importation provisions. This is because the actualization of those provisions would now require U.S. administration support but the president, by virtue of his past opposition to drug importation, is not expected to offer that support.

Even if the provisions were to be put into force, the administrative burden included in the bill, which is 140 pages long, is so onerous that its implementation would be significantly slowed. Its extensive administration and oversight regime includes requirements for inspections of exporting facilities and multiple procedural requirements of both exporters and importers. This suggests that there would be very slow uptake in the provisions.

I could go on but the bottom line--

Food and Drugs ActPrivate Members' Business

6:45 p.m.


The Acting Speaker Conservative Andrew Scheer

We need to move on. Resuming debate, the hon. member for Québec.

Food and Drugs ActPrivate Members' Business

6:45 p.m.


Christiane Gagnon Bloc Québec, QC

Mr. Speaker, today we are examining Bill C-378, which seeks to control the cross-border trade of prescription drugs and vaccines.

Bill C-378 could be an answer to concerns about reductions in inventories of drugs designated for Canadians. It also seeks to restrict bulk exports of drugs. Although there is no shortage at present, this bill would establish preventive measures to avoid such a situation. Regulating drug exports would prevent an unfortunate situation from arising.

Bill C-378 seeks to restrict drug exports within the framework of NAFTA. According to this agreement, it is possible to limit exports to prevent a shortage. In the event of a shortage, the federal government could prohibit bulk exports of drugs in order to retain a sufficient inventory in Canada to safeguard public safety. Hence, the bill would give effect to these provisions.

Earlier I was saying that this bill could allay concerns about the possibility of reductions in drug inventories. However, the Bloc Québécois does have to raise one question. Although there seems to be a consensus on this issue, there are nevertheless some points to consider that are of particular interest to me. First, is there a risk of meddling in Quebec's jurisdiction if more powers are given to the federal minister? Second, does the Minister of Health not already have the authority to act in the event of an emergency? Third, it is not really clear that the United States would allow bulk importing given the power of the pharmaceutical lobby and President Bush's opposition to such a measure. Fourth, along the same lines, could the government act quickly if the United States decided to allow bulk importing? One might think that, under NAFTA and the WTO, there are already measures to protect against bulk purchasing of drugs, for example.

All these questions are apparently on the table and the introduction of this bill is certainly interesting. Nonetheless, as far as passing this bill is concerned, we are not there yet. In my opinion, we need more time since this evening's debate is the first one this House has held on this situation. We know that some sectors, including the Canadian Pharmacists Association, are worried about prescription drug inventories, which could be seriously jeopardized if such a situation prevailed. Apparently, if every American decided to buy drugs in Canada, after 38 days of making their purchases here, there would be no drug supplies left for Quebeckers and Canadians.

This is certainly a compelling matter and it requires us to look at this problem, which is currently not as much of an issue as it once was. We should perhaps qualify the dangerous situation we could find ourselves in. Why did the Americans want to buy their drugs here in Canada? Because the exchange rate was really good for the Americans. Since the value of the Canadian dollar has gone up, the Americans' appetite to buy in Canada is probably not as real today. That is my first observation.

The second observation is that there was a time when a lot of prescription drugs were being bought here in Canada. What is happening now is that the U.S. government implemented the medical insurance system called Medicare. This has slowed the Americans zeal to buy in Canada. Many people who were in a more vulnerable situation for purchasing drugs no longer do so here. The situation may not be as problematic as it was a year ago.

The volume of purchases has also declined. People came here to buy prescription drugs and they bought them through Internet pharmacies, which were a serious problem for some pharmacies that lost their pharmacists. Working for Internet pharmacies appealed to a lot of pharmacists. Small pharmacies began to lose their professional resources to lucrative positions with Internet pharmacies.

The situation in Quebec is perhaps a little different. I am not saying that nobody in the pharmaceutical industry is concerned, but in Quebec, we have set up some protection, and we know that Ontario has done the same. Western provinces are the ones trying to come to terms with Internet pharmacies. The provinces could just adopt legislation, but it is not up to me to tell other provinces what to do. I would rather talk about what Quebec has done to protect itself from various possible situations.

As in many other areas, Quebec is way ahead in terms of the sale and monitoring of prescription drugs. It has measures to prevent the online sale of prescriptions drugs to American clients. Under Quebec's Pharmacy Act, a pharmacist can sell prescription drugs only to patients whose prescriptions were written by a person authorized under Quebec law or the laws of another Canadian province to prescribe the drug if that person practices in Quebec. That makes it harder to do.

Furthermore, the Code of Ethics of Physicians states that in order to give a prescription to a patient, a physician in Quebec must have assessed the patient. If an American wants to buy prescription drugs online or in person, he must see a Quebec physician. A Quebec physician must assess the patient, make a diagnosis, develop a treatment plan, provide information and obtain consent.

I am rather concerned about that. It is all well and fine to buy drugs on the Internet or through other means, but one must also consider the quality of the product. Responsibility for a product can hardly be ensured when there is no medical prescription and the patient was never seen by a doctor. Many Americans should think about that too, because we cannot tell who is responsible for product quality and for providing the right treatment to the right patient.

In Quebec, efforts have been made to oversee a process with potentially serious consequences, since it is often difficult to undo things where people's health is concerned.

Already, the Collège des médecins du Québec has struck physicians off the roll for having illegally sold drugs on the Internet to Americans they had never even met. That is not a common occurrence, but it has happened. Nor are practising physicians in Quebec allowed to countersign a prescription from another physician without complying with the same requirements as for the prescription. A Quebec physician who countersigns a prescription from an American physician risks being sued, not only in Quebec, but also in the United States. Clearly, Quebec has tried to provide the best framework possible for all these transactions which could have a harmful effect on the health of individuals.

In terms of online business, Quebec already has the necessary tools to protect pharmacies' supply and ensure that patients receive the appropriate medication for their condition and information on how to use it. Some control is needed, and this bill might motivate the provinces to take action to increase protection and improve control. Physicians who did not comply with this procedure would risk prosecution. Harsh penalties have been applied, and some operations have even been shut down. Some practitioners were required to restrict their professional activities for 18 months and even pay fines for illegally running a business that was not approved.

This bill requires that we take a serious look at the situation. Hon. members will see from our questions how the Bloc Québécois receives Bill C-378 for the benefit of the public.

Food and Drugs ActPrivate Members' Business

6:55 p.m.


Penny Priddy NDP Surrey North, BC

Mr. Speaker, I will follow up on the comments of my colleague who just spoke. This is indeed a bill that merits our attention. It is an issue that merits our attention. I think that in some ways we have had intermittent attention paid to it around Internet pharmacies, but perhaps not in the larger perspective of what drug exportation has the potential to mean.

In my understanding of the bill, and I will look to my Liberal colleague to be nodding or shaking her head if I misspeak, there is a concern that for Canadians, for the most part in some kind of emergency, drugs would not be available because we would have a shortage through bulk exportation or exportation in large amounts to the United States. The example that my Liberal colleague from St. Paul's used was around Tamiflu.

There are a couple of things that affect this. When the United States politicians introduced the pharmaceutical market access and drug safety act, and I believe it was in 2007, I think that efforts or initiatives were stepped up in order to be able to access bulk exports on an even greater basis, because that act appeared to be opening even further a door that was probably open anyway but was going to be open on a much more official kind of basis.

I live in the border city of Surrey. Our 400,000 people make us a city. I do not think that this bill is intended to stop the carload of senior citizens who drive up there from Bellingham to get their personal prescriptions filled. I think we have to be clear about how the bill is not intended to simply completely close down the gates to any kind of sharing or purchasing of drugs by American citizens.

We know that we are very fortunate in this country. Although our system could be better in that we could have a national drug plan, and we are working on it, that is for another day, We are able to have our prescriptions at prices that are more affordable for us than they are for many American citizens who indeed either cannot afford them or do not have coverage.

There are somewhere around 250 million Americans who do not have any medical coverage whatsoever and they are not going to be able to afford prescriptions anyway. While we have some people in those circumstances, it is much more severe in the United States. I do not think this bill is saying that those kinds of people would not be able to access any drugs at all from Canada.

However, I think there has been a dramatic expansion and there is a potential for a dramatic expansion of importation to the U.S. of drugs in large bulk amounts. That is perhaps a bit different from what we heard from another colleague. With the United States opening the door, and with manufacturers here who I am sure would be willing to sell in bulk amounts, I think that would be a dramatic expansion.

I do not think there is any question that the business of Internet pharmacies has decreased. I hope, as my Liberal colleague does, that it is because people perhaps have a greater understanding of what some of the risks might be and are able to access those drugs at home. This is not about the expansion or contraction of Internet pharmacies filling individual prescriptions, although those indeed are dropping.

There is an interesting question about this that I get asked all the time when this comes up. It has come up in B.C. a number of times as we see people coming in from the United States. People say that this will probably create jobs, so why can the manufacturers not put on more shifts and manufacture more drugs? It is perfect, they say, there is the solution.

However, the manufacture of drugs does not work in the same way that manufacturing tomato sauce works. Some of those drugs have ingredients that are perhaps more scarce in terms of their biological sources. Also, it takes time to manufacture additional amounts of drugs.

As well, many medications are time dated, so drug manufacturers cannot just create a warehouse or a storehouse full of medications that are ready to export when somebody asks for them. They may be out of date, and the manufacturers are not going to have the excess sitting on their shelves, excess that they have not been able to forecast. They do their business based on forecasting, which is primarily based on the needs of Canadian patients. That is where they develop their business plan. They develop it on what they see as the trend line in medications that are being used and approved in Canada.

There are two other things I want to mention. I have seen what happens in emergencies. Not every drug that would be bulk exported is a vaccine, and I understand that, but vaccines are part of that bulk export. When SARS hit Canada, I was at Home Depot one day and saw people pushing huge carts full of crates and crates of masks out of the store. By the way, those little paper masks would not have done any good anyway, as we discovered. As we probably know anyway, they not terribly effective, but people were hoarding them in case something happened.

In any kind of an emergency there is this human response to hoard: drugs, food, things that will protect us, water, or whatever it might be. I worry that in the case of that emergency where a vaccine is needed, and again, Tamiflu is the example that was used, there might be a health risk for Canadians. I want everybody to be healthy. I want Americans, Canadians and people around the world to be healthy, but we have a responsibility as legislators of this country and as people involved in health to ensure that there are the health resources necessary to meet the needs of Canadian citizens.

When we are talking about bulk exporting, I have another concern. My understanding is that regulators at the border have said that they have an opportunity to check only about 1% of what crosses the border. We all know that there are such things as counterfeit drugs. I do not think there are going to be people looking to see whether these are counterfeit drugs that are being shipped across the border or whether they are being shipped across the border in a box that says “Christmas presents for Aunt Millie”.

Mr. Speaker is telling me that I have one minute left. I look forward to further debate on this bill, but when we are looking at bulk exports, I do think that there are many risks involved and it is only responsible of the Government of Canada to look at this and ensure that Canadians are protected first.

Food and Drugs ActPrivate Members' Business

7:05 p.m.


Scott Brison Liberal Kings—Hants, NS

Mr. Speaker, I am pleased to rise this evening to speak to this important legislation introduced by the hon. member for St. Paul's, who was absolutely the very best minister of public health in the history of Canada, and few would debate that.

I served in cabinet with the hon. member and she brought to the cabinet table a tremendous understanding of health and wellness issues. In fact, I remember her from time to time saying as a minister that we in Canada do not necessarily have a health care system, we have a sick care system.

We look after people only when they are sick. We do not do enough on wellness and preventative medicine, and helping keep people well. She brought a great sense of knowledge, practicality, and at the same time, vision to her role as minister of public health. I am very pleased to support her bill today.

The whole issue of bulk import of drugs into the United States is an extremely important one. In the U.S., the cost of drugs to Americans is a tremendously politically charged issue. It is one that is at the very centre of the health care debate in the U.S.

We all know the challenges that our own health care system here in Canada faces, but the U.S. health care system is under even more pressure because of the inefficiencies and ineffective nature of the private insurance system and some of the other challenges facing the U.S. system.

American legislators are debating, and have debated, the whole idea of allowing bulk import of drugs from Canada through Internet pharmacies. In fact, what they are doing is trying to achieve what we have achieved here in Canada in terms of our regulatory framework around drug pricing.

The more efficient approach for them to take, and the less intrusive approach in terms of the impact on our public policy and our citizens, would be for them to simply regulate their drugs with a similar approach to our approach here in Canada, which effectively assures Canadians good access to important and lifesaving pharmaceuticals at a more reasonable price.

Instead of that, the legislators like to say that they will not regulate drug prices in the United States of America, but instead of regulating them there they outsource the regulation to Canada. That sounds perfectly innocent to Canadians. It does not sound like a big deal until we consider what the impact will be on our own drug supplies here in Canada.

The goal of the drug pricing regime we have in Canada is to ensure that Canadians have access to the pharmaceuticals they need at a reasonable price. It was never intended to, and never designed to, provide Americans with drug prices at a low cost.

American politicians are saying they are against price regulations. It is kind of an ideological perspective, not unlike our colleagues opposite sometimes on certain issues if I may say that respectfully, and similarly wrong as well. The fact is what they are doing by outsourcing their drug pricing regime to Canada is actually jeopardizing the access for Canadians to the drugs they need at reasonable prices.

The question we have to ask ourselves is this. Why would multi-national pharmaceutical companies that invest billions of dollars into research and development continue to supply Canada to the same extent that they have in the past if in fact the products they were shipping to Canada were being used to effectively cannibalize the market in the U.S. and reduce their profits?

It stands to reason that in a market-based economy they will make a decision to the benefit of their shareholders that will effectively prevent Canadians from having access to the drugs that they need at the price they want.

It is important for us to do two things. First, we need to ban the export of pharmaceuticals to the U.S. Our pricing regime was never intended to create some artificial regulatory arbitrage between the two countries which have very clever entrepreneurs. I have a lot of respect for entrepreneurs as I, my dad and my grandfather were all entrepreneurs. However, whenever there is a difference in regulatory regimes there is a potential for some sort of arbitrage, and that, effectively, is what is going on here.

No value is being created by the bulk export. It is not a sustainable industry. It is one that has a nascent profitability but it is one that, while it provides some pure profitability, it does jeopardize the long term access Canadians have to the drugs they need at reasonable prices.

I think we need to make the point very clear with American legislators that they cannot simply continue to avoid the debate on issues like drug regulatory frameworks. We also need to point out to organizations like the American Association of Retired People and others, the equivalent of CARP here in Canada, that what they are pushing for is not even in the long term interest of Americans.

Not only is this dangerous for Canadians in terms of reducing our citizens' capacity to have the drugs they need, but in the long term it actually does jeopardize the security of the pharmaceutical supply chain to Americans.

First, we need to ban the export of drugs to Internet pharmacies to the U.S. and, second, we need to make it very clear to American legislators and perhaps to Americans directly that this type of short term band-aid solution could jeopardize the security of their supply chain for their pharmaceuticals in the long term. Therefore, it is a no win situation for citizens on both sides of the border.

Food and Drugs ActPrivate Members' Business

7:10 p.m.


The Acting Speaker Conservative Andrew Scheer

The time provided for the consideration of private members' business has now expired and the order is dropped to the bottom of the order of precedence on the order paper.

A motion to adjourn the House under Standing Order 38 deemed to have been moved.

7:10 p.m.


Dennis Bevington NDP Western Arctic, NT

Mr. Speaker, I rise on an issue that I raised in question period a number of weeks ago. I have raised this issue many times in the House of Commons. It deals with the fairness in the tax system as it applies to the northern residents tax deduction.

I have made the point over the year that this northern residents tax deduction, which was put in place by the Conservative government in the late eighties to assist northerners with the high cost of living, has remained at the same level throughout 20 years.

The benefit from this program has degraded over that time. We really need to see some fairness put into this program and see that the northern residents tax deduction be brought forward and raised at least by the amount of inflation over the period of the 20 years.

I would note as well that in the federal budget this time the issue of fairness was raised as it concerned the capital gains exemption for small businesses. It, too, had been in place for 20 years and was put in place at a half a million dollars. In the new budget, it was raised to $750,000 under the policy of fairness to the people who would of course get the benefit from that capital gains exemption.

So, we have seen that fairness is a part of the Conservative rhetoric on the budget. I would hope that the Conservatives would consider it when it comes to this very important part of the tax system to northerners.

When I speak of northerners, I am not speaking simply of my riding, the Northwest Territories, but also Yukon, Nunavut and of course many of the northern ridings that stretch across the provinces in the north. There are quite a number of ridings that have residents who are affected by and take advantage of the northern residents tax deduction.

When it was introduced, the policy objectives of the northern residents tax deduction were to create a stable and trained resident workforce in the north. The disincentives to this were, of course, the high cost of living.

I do not have to raise this too much here, but the cost of living in the north, across northern isolated communities across this whole country, is extremely high. In some cases, it is twice that of southern Canada and even higher than that in many cases.

Although there may be high wages for some people in northern situations, those wages have not made that much of a difference because, as the progressive tax system in Canada works, the higher wages, the more taxes paid.

Due to the high cost of living, northerners are also taxed more through the consumption tax known as GST. The cost of goods are more. Northerners are paying more for the basic cost of living, so they are paying more for the taxes that are applied to that cost of living through the GST.

There is also reduced access to goods and services. So, when people do purchase items in the north, when they look for services, they by and large have to pay much more than southern Canadians.

Of course, the additional costs that come from the extreme climate conditions in the north, for example, in Tuktuyaktuk--