Mr. Speaker, I would like to thank my colleague from Cumberland—Colchester for sharing her time with me.
Our government is committed to providing the first nations and Inuit access to the health services they need, including the necessary medical benefits coverage provided by the non-insured health benefits program, the NIHB.
The NIHB program delivered by Indigenous Services Canada is one of the largest supplemental health benefits programs in the country. This program is national in scope and provides the necessary health benefits to roughly 868,000 eligible first nations and Inuit clients, both on and off reserve. Last year, the NIHB program spent more than $1 billion on providing access to these medically necessary health benefits and services.
The NIHB program provides significant coverage in different insurance zones that is complementary to the insurance already provided by the provinces, territories and private insurers. This includes prescription drugs, non-prescription drugs, medical supplies and equipment, mental health counselling, dental care, vision care, and medical transportation where health services are not available in the community.
Access to affordable medication is not just a provincial responsibility. The federal government administers five separate drug plans for first nations and Inuit peoples, for offenders in federal correctional institutions, for members of the military, for members of the RCMP and for veterans.
The NIHB program gives eligible first nations and Inuit peoples coverage for the prescription medications and over-the-counter drugs included in the NIHB drug benefit list when they are prescribed by a health care professional. The NIHB drug benefit list currently includes about 900 chemical entities, or about 8,500 separate drug identification numbers, known as DINs.
I should also note that coverage for certain drugs not included in the drug benefits list may be approved under exceptional circumstances. Unlike many other programs, the NIHB does not require eligible clients to pay a co-pay or deductible, and health care providers are encouraged to bill the program directly so that clients do not incur any additional fees. Federal drug plans have adopted an approach focused on assessing health technologies, to ensure that pharmaceutical products are accessible, affordable and appropriate for clients.
Once a drug is approved for sale in Canada, our country's public drug plans, including the NIHB program, must decide whether the drug will be eligible for public reimbursement. To facilitate this decision-making process, Indigenous Services Canada, along with the other administrators of federal drug plans, fully participates in the common drug review and the pan-Canadian oncology drug review, which are managed by the Canadian Agency for Drugs and Technologies in Health, or CADTH.
As part of its reviews, CADTH conducts objective evaluations of the clinical, economic and patient evidence on drugs and uses this evaluation to provide reimbursement recommendations and advice to Canada's federal, provincial and territorial public drug plans. Public drug plans, including the NIHB program, make their final decisions on whether to reimburse or cover drugs based on the recommendations of CADTH and on other factors, such as the plan's mandate, jurisdictional priorities and budgetary implications.
If necessary, price negotiations will take place to improve cost effectiveness.
Last year, a single drug class, biologic anti-inflammatory drugs used to treat certain autoimmune diseases such as rheumatoid arthritis, accounted for 10% of the pharmaceutical market, with sales totalling over $2 billion in Canada. That is a lot of money.
It is worth mentioning that we pay approximately 25% more to treat arthritis than other countries with similar markets. For example, in Ontario, the top selling arthritis drug costs nearly $30,000 per year. In France, that same drug costs about $22,000 per year. If Canada paid the same price as France, we would have saved $220 million a year last year on that drug alone. Any failure to get the best price for a drug is a missed opportunity to do more for Canadians.
We can do better. The work has already begun. The federal, provincial and territorial governments came together to create the pan-Canadian pharmaceutical alliance, or pCPA. The pCPA negotiates drug prices on behalf of public drug plans. By harnessing the collective purchasing power of governments to negotiate the best price, we will save more and more money. We will continue to work to that same end as new drugs are added.
Treatment for hepatitis C is a good example. Hepatitis C can be debilitating and fatal. If left untreated, it can lead to liver failure and cancer. New hepatitis C treatments are effective for many patients, but they cost between $45,000 and $100,000 per patient.
In February 2017, the pCPA succeeded in lowering the cost of hepatitis C drugs. For public drug plans, lower prices mean more patients can get better treatment sooner. That is proof that working together makes the provinces and the country stronger and better able to make good decisions and work on reducing drug costs.
As a full member of the pCPA, the non-insured health benefits program, the NIHB, is implementing new agreements negotiated by the pCPA, which is making new drugs more affordable and more accessible for members of first nations and Inuit communities.
We recognize that there are serious problems related to substance use disorders across Canada, including in indigenous communities. The government takes the issue of client safety very seriously. The NIHB program is recognized as a national leader when it comes to efforts to address substance use disorders and protect client safety. It has implemented a broad range of measures over the past decade to ensure that clients receive the medication they need without putting them in danger.
Here are some examples of such measures: using warning and reject messages in real time to alert pharmacists of potentially worrisome situations regarding safety; introducing dosage and quantity limits, thereby limiting the quantity of drugs a client can receive; and imposing access restrictions on drugs when there is a safety risk or risk of diversion.
To detect high-risk drug tendencies, potentially inappropriate licensing and other safety problems, the NIHB program has a formal monitoring program, which directly implicates prescribers and providers when concerning trends are detected. Clients whose drug utilization patterns indicate an increased risk are entered into the client safety program.
Furthermore, the NIHB is guided by the Drugs and Therapeutics Advisory Committee, known as DTAC, which makes recommendations with respect to drug policies and the drug formulary. The DTAC is an advisory body of highly qualified health professionals who bring impartial and practical expert medical and pharmaceutical advice to the NIHB program to promote improvement in the health outcomes of first nations.
The approach is evidence-based and the advice reflects medical and scientific knowledge, current utilization trends, current clinical practice, health care delivery and specific departmental client health care needs.