Mr. Speaker, with respect to Health Canada, questions related to the treatment and diagnosis of chronic cerebro-spinal venous insufficiency, CCSVI, are of a clinical nature and are best directed toward the provinces and territories and their respective physician associations. The Canada Health Act requires provincial and territorial health insurance plans to provide medically necessary hospital and physician services to their residents on a prepaid basis, and on uniform terms and conditions. The provincial and territorial governments, in consultation with their respective physician associations, are primarily responsible for determining whether new treatments for CCSVI are medically necessary for health insurance purposes.
With respect to Canadian Institutes of Health Research, through the CIHR, the government is funding health research on multiple sclerosis, MS. In 2008-09 investments related to MS totalled approximately $5.3 million. CIHR also invested $120.5 million in the larger area of neurosciences research in 2008-2009 and approximately $38 million in stem cell research which is being pursued for the potentially useful therapies it may offer in the treatment of health conditions and diseases such as multiple sclerosis. CIHR also funds a great deal of research related to stroke, much of which focuses on the vascular component of the disease. In 2008/09 CIHR funded approximately $22.9 million in stroke research. All of these investments are building our overall understanding of multiple sclerosis toward more effective treatment and ultimately a cure. CIHR has been consulting with the research community and will be convening, in close collaboration with the MS Society, an international meeting of top scientists to identify research priorities for Canada and accelerate research and innovation on MS.
CIHR has not funded research on the possible relationship between MS and impaired venous drainage of the central nervous system or CCSVI since no researchers working in this area have applied for funding. However, CIHR is funding Drs. Bruce Pike and Douglas Arnold of McGill University who are working to advance functional magnetic resonance imaging to permit robust and continuous monitoring of cerebral blood flow, volume, and oxygen consumption. While their study is targeted to Alzheimer’s patients, the results will also increase our knowledge of the role that obstructed blood flow may play in MS. Drs. Pike, Arnold and Dr. John Sled are also collaborating on research to develop an MRI technique more able to detect tissue damage than current methods. The research will allow the tissue damage in MS patients to be comprehensively and quantitatively assessed, will lead to increased knowledge on the natural evolution of the disease and will enable the evaluation of new therapies that attempt to slow or stop the progression of this disease.
It is quite possible that the recent interest in the possible relationship to multiple sclerosis of impaired venous drainage of the central nervous system, or, Chronic cerebrospinal venous insufficiency (CCSVI), will draw more scientists to pursue MS research. CIHR would welcome funding applications through its ongoing programs such as the Open Operating Grants competition. The next competition has a registration deadline date of August 16 and an application deadline date of September 15.
With respect to Public Health Agency of Canada, estimates from the 2000-2001 Canadian Community Health Survey indicate that approximately 57,600 Canadians aged 12 and older living in private households have been diagnosed with MS by a health professional. This estimate does not include individuals living in institutions. The National Population Health Study on Neurological Conditions announced by the federal Minister of Health on June 5, 2009 will provide additional data by 2013.
(i) Estimates from the 2000-2001 Canadian Community Health Survey indicate that of individuals aged 15 years to 75 years of age who have MS, 23% reported that they were permanently unable to work. Updated information on labour force participation among individuals with MS will become available with the National Population Health Study on Neurological Conditions.
(ii) Although the 2000-2001 Canadian Community Health Survey included an optional module on home care, the survey module included too few individuals with MS to report reliable estimates of the percentage of MS patients who depend on family caregivers. The purpose of the 4-year National Population Health Study on Neurological Conditions is to fill gaps in knowledge about individuals with neurological conditions, their families, and caregivers.
(iii) An estimate of the percentage of MS patients in Canada who require around-the-clock care from professional caregivers is not currently available. A component of the 4-year National Population Health Study on Neurological Conditions will measure the prevalence of selected neurological chronic conditions among the institutionalized population and will provide new estimates on Canadians with neurological conditions, including MS, who are receiving care in nursing homes that provide 24-hour care.
The Public Health Agency of Canada estimates that the direct health care costs and costs from loss of economic productivity associated with MS in 2000-2001 were $950.5 million. Direct costs associated with MS estimated in 2000-2001 were $139.2 million: $58.4 million for hospital care, $12.1 million for physician care and $68.7 million for drugs. Indirect costs associated with MS estimated in 2000-2001 were $811.3 million: $172.8 million (21.3%) in loss productivity due to premature mortality and $638.45 million (78.7%) in long-term disability costs. Short-term disability costs are not included in the estimates of morbidity costs, and therefore underestimate indirect costs. Source: Canadian Institute for Health Information, The Burden of Neurological Diseases, Disorders and Injuries in Canada (Ottawa: CIHI, 2007). www.cihi.ca