Debates of Jan. 29th, 2024

Question No.2154—

[Ted Falk, Conservative, Provencher, MB]

With regard to Health Canada monitoring Pfizer's COVID-19 vaccine: (a) did Health Canada (HC), the Public Health Agency of Canada (PHAC), the National Advisory Committee on Immunization (NACI) or Canadian Institute for Health Information (CIHI) receive the report entitled Pregnancy and Lactation, Cumulative Review from Pharmacovigilance Database, dated April 20, 2021, or an equivalent document; (b) if the answer to (a) is affirmative, what are the details, including the (i) date HC, PHAC, NACI or CIHI received a report outlining clinical data any period from the time of drug product development to the end of the first six months of the roll out, (ii) report name, (iii) percentage of pregnant women who reported adverse events, (iv) percentage of lactating women who reported adverse events in themselves and their newborns; (c) what is HC's analysis of the document in (a) relative to, (i) premature deliveries, (ii) miscarriages, (iii) spontaneous abortions, (iv) stillbirths, (v) maternal deaths, (vi) the percentage of pregnant women who reported adverse events, (vii) the percentage of lactating women who reported adverse events in themselves or their newborns; (d) if the answer to (a) is negative does HC, PHAC, NACI or CIHI plan to request this report or equivalent report from Pfizer; (e) with respect to passive surveillance, what is the established threshold for conditions listed in (c) (i) to (v) for withdrawing approval for this population; (f) for institutions who met the continuous review of global vaccine safety surveillance rule which showed no evidence of any adverse pregnancy or neonatal outcomes associated with COVID-19 vaccination, what are the (i) institution names, (ii) links, (iii) supporting document names?

[Mark Holland, Liberal, Minister of Health]

Mr. Speaker, with regard to part (a), Health Canada did not receive the above-mentioned report. With regard to part (b), the answer is nil, as per (a). With regard to part (c), the answer is nil, as per (a).

With regard to part (d), Health Canada has a robust vaccine safety surveillance system in place that engages health care professionals, vaccine manufacturers, the Public Health Agency of Canada, PHAC, and the provincial and territorial health authorities. Through these measures, manufacturers are required to submit safety data from real-world use and results related to safety and effectiveness from ongoing and planned studies as they become available.

In addition, Health Canada and the Public Health Agency of Canada have been actively monitoring and reviewing reports of adverse events following immunization, AEFI, reported to the Canada vigilance program, at https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/canada-vigilance-program.html, and the Canadian adverse events following immunization surveillance system, at https://www.canada.ca/en/public-health/services/immunization/canadian-adverse-events-following-immunization-surveillance-system-caefiss.html. This information is published on the Government of Canada’s website at https://health-infobase.canada.ca/covid-19/vaccine-safety/. As noted on this website, there were 95 reports of spontaneous abortion up to and including September 15, 2023. It is important to note that these reports do not necessarily imply that a relationship between the adverse event and the vaccine has been established. However, they are an important source of information supporting ongoing safety monitoring. Health Canada also monitors and considers information from the scientific literature and international regulators.

Health Canada will not request the above-mentioned report separately since the report is now outdated. However, on October 22, 2022, Health Canada published a summary of the review on the use of the mRNA COVID-19 vaccines Comirnaty and Spikevax during pregnancy and breastfeeding, which included adverse events reported to Health Canada. Information about the summary of the review is available by clinking on this website: https://www.canada.ca/content/dam/hc-sc/documents/services/drugs-health-products/medeffect-canada/health-product-infowatch/october-2022/health-product-infowatch-october-2022.pdf.

Health Canada continues to monitor the safety of COVID-19 vaccines approved in Canada to help ensure that the benefits continue to outweigh the risks for all groups of individuals, including pregnant and lactating women. Should there be new safety issues identified, Health Canada will take action, as appropriate.

From the National Advisory Committee on Immunization, NACI, the summary of evidence and rationale for NACI’s pregnancy and breastfeeding recommendations was updated to reference developmental and reproductive toxicity, DART, animal studies for COVID-19 vaccines as those became available throughout 2020 and 2021. The relevant evidence was summarized in each update to NACI COVID 19 recommendations. In September 2022, as more evidence accumulated, NACI revised public health advice to strongly recommend that COVID-19 vaccines should be offered to those who are pregnant or breastfeeding, based on a review of global vaccine safety surveillance, vaccine effectiveness, vaccine safety studies and Canadian epidemiology. This included information from the Canadian National Vaccine Safety Network study, which started in December 2020, and the COVID-19 vaccine registry for pregnant and lactating individuals, which was launched in July 2021.

With regard to part (e), none of the COVID-19 vaccine manufacturers sought indications for use in pregnant or lactating women or submitted randomized clinical trial data in pregnant or lactating women for regulatory evaluation. The product monographs included statements about the uncertainties related to pregnancy and lactation. A change to the approved conditions of use for a drug, including vaccines, or removal of a drug from the market is based upon the available evidence regarding the risks and benefits of the drug. There is no specific threshold but rather a scientific evaluation of the balance of risks and benefits. If the available evidence, including data obtained through passive surveillance, indicates that the risks outweigh the benefits, Health Canada will take appropriate action. This action may include changes to the conditions of use of a drug, such as contraindicating use for some groups, or complete removal of the drug from the market. Should such action be taken, Health Canada would also communicate the risk to Canadians and health care providers.

With regard to part (f), while Health Canada has no information on institutions that met continuous review of the global vaccine safety surveillance rule, we understand that vaccine safety is monitored worldwide by health authorities. This information can be found on the official websites of international health authorities.

Question No.2158—

[Lisa Marie Barron, NDP, Nanaimo—Ladysmith, BC]

With regard to the conditions of licence for marine finfish aquaculture in British Columbia and the licence issued to Cermaq for its aquaculture farm at Bawden Point: (a) what were the dates of all licenses issued to Cermaq to operate its farm at Bawden Point since January 2015; (b) was Cermaq ever found in violation of the licenses it was issued and, if so, what are the reasons for breach of license; (c) were the licenses issued to Cermaq in (a) amended to allow for higher sea lice thresholds; (d) what are the details of all amendments in (c); and (e) was Cermaq fined or otherwise reprimanded for violations of the licenses it was issued?

[Diane Lebouthillier, Liberal, Minister of Fisheries]

Mr. Speaker, with regard to the conditions of licence for marine finfish aquaculture in British Columbia and the licence issued to Cermaq for its aquaculture farm at Bawden Point, the dates of all licences since January 2015 are September 12, 2023; March 9, 2023; August 16, 2022; July 1, 2022; March 1, 2020; November 17, 2016; November 10, 2016; July 1, 2016; December 19, 2015; and September 8, 2015.

The following violations are documented at the Bawden Point facility: 17 late reports from 2016-23; and one instance of failing to conduct sea lice abundance assessments in 2018.

Licences issued to Cermaq were not amended. There is no record of Cermaq being fined or otherwise reprimanded for the documented violations.

Question No.2162—

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

With regard to Health Canada’s use of preclinical manufacturer’s data for authorizing COVID-19 vaccines: (a) did Health Canada (HC), the Public Health Agency of Canada (PHAC) and the National Advisory Committee on Immunization (NACI) follow The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) standards; (b) were Developmental and Reproductive Toxicity (DART) guidelines required to be met for the determination of safety for either the Pfizer or the Moderna products for pregnant and lactating mothers; (c) if the answer to (b) is affirmative, (i) did the animal studies assess any effects within a complete reproductive cycle from conception to the reproductive capacity of the next generation, (ii) did the animal studies evaluate long term outcomes in offspring, (iii) were any fetal or offspring abnormalities detected, (iv) what fetal or offspring abnormalities were detected, (v) what is the significance of the fetal or offspring abnormalities in defining safety, (vi) were any adverse events observed in the mothers, (vii) what is the significance of adverse events observed in the mothers for human safety, (viii) was decreased fertility detected in the first or second generation, (ix) were biodistribution studies conducted in the pregnant animals and their fetuses, (x) were alternate routes of exposure studied in the animals including through mating with a vaccinated male or transmammary routes; (d) if the answer to (b) is negative, what requirements needed to be met with respect to DART prior to the interim order approval and after the interim approval?

[Mark Holland, Liberal, Minister of Health]

Mr. Speaker, with regard to part (a), yes, the non-clinical studies submitted to Health Canada to support the approval of the COVID-19 vaccines were conducted in accordance with the ICH standards. In particular, the ICH safety guideline S5(R3), detection of reproductive and developmental toxicity for human pharmaceuticals, has specific requirements for the design and conduct of developmental and reproductive toxicity studies for vaccines. This guideline provides information on animal species selection as well as dose selection and study design for vaccines against infectious diseases.

Health Canada is responsible for the regulatory authorization of vaccines, which encompasses the review and assessment of various studies to ensure the safety and efficacy of vaccines. The National Advisory Committee on Immunization, NACI, primarily focuses on analyzing data from human clinical trials to provide vaccine safety recommendations. NACI's role is not directly involved in the regulatory authorization process or in the initial review of safety and efficacy studies.

With regard to part (b), yes, DART studies were required as part of the regulatory evaluation of COVID-19 vaccines. These studies were conducted in accordance with ICH guidelines in S5(R3). These studies were submitted for regulatory review and supported the approval of the COVID-19 vaccines. The outcomes of these studies were included in the relevant documents prepared and published by Health Canada to inform the public, health care professionals and researchers. This information can be found under each specific product. For Comirnaty, from Pfizer-BioNTech, the product monograph is at https://covid-vaccine.canada.ca/info/pdf/pfizer-biontech-covid-19-vaccine-pm1-en.pdf and the summary basis of decision is at https://covid-vaccine.canada.ca/info/SBD00510-comirnaty-en.html. For Spikevax, from Moderna, the product monograph is at https://covid-vaccine.canada.ca/info/pdf/covid-19-vaccine-moderna-pm-en.pdf and the summary basis of decision is at https://covid-vaccine.canada.ca/info/SBD00511-spikevax-en.html.

It should be noted that the vaccine manufacturers did not seek an indication for use in pregnant and lactating women and that the product monographs included statements about the uncertainty regarding safety and efficacy in pregnancy and lactation. At the time of approval, there was limited experience with the use of COVID-19 vaccines in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryo or fetal development, parturition or postnatal development, and human randomized clinical trials were not submitted for regulatory evaluation.

With regard to part (c), as indicated above, DART studies were required as part of the regulatory evaluation of COVID-19 vaccines. DART studies are required to detect any effects of the vaccine within a complete reproductive cycle as relevant to humans, from initial conception to reproductive capacity. No vaccine-related adverse effects on female fertility, fetal development or postnatal development were reported in the studies for the vaccines. Excerpts from the product monographs are included below.

As to Comirnaty’s reproductive and developmental toxicology, in a reproductive and developmental toxicity study, 30 micrograms per animal, or 0.06 millilitres of a vaccine formulation containing the same quantity of nucleoside-modified messenger ribonucleic acid, mRNA, and other ingredients included in a single human dose, of Comirnaty was administered to female rats by the intramuscular route on four occasions: 21 and 14 days prior to mating and on gestation days nine and 20. No vaccine-related adverse effects on female fertility, fetal development or postnatal development were reported in the study.

As to Spikevax’s reproductive and developmental toxicology, in a pre- and postnatal developmental toxicity study, 0.2 millilitres of a vaccine formulation containing the same quantity of mRNA, 100 micrograms, and other ingredients included in a single human dose of Spikevax was administered to female rats by the intramuscular route on four occasions: 28 and 14 days prior to mating and on gestation days one and 13. No vaccine-related adverse effects on female fertility, fetal development or postnatal development were reported in the study.

Part (d) is not applicable. Please see response to part (b).

Question No.2163—

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

With regard to Health Canada’s COVID-19 vaccine safety monitoring and assessment for pregnant and lactating (P&L) women: (a) are observational trials and surveillance systems adequate to establish safety or must this be accomplished through randomized trials; (b) were randomized control trials (RCTs) used to obtain approval and support safety claims in P&L women, and, if so, what are the details, including, the (i) name of the trial, (ii) date of the trial; (c) did the trials in (b) (i) include all trimesters, (ii) include high risk pregnancies, (iii) include clinical and sub-clinical testing, (iv) include a trial group measured against a placebo control group, (v) include a control group which remained intact for multiple years to establish long term safety data, (vi) be sufficiently powered to detect common and rare side-effects; (d) if the answer to (b) is negative, what trials were used to evaluate the safety in the P&L population prior to approval in this cohort, including the (i) trial name, (ii) trial date, (iii) analysis of the trial; (e) did Health Canada (HC), the Public Health Agency of Canada, the National Advisory Committee on Immunization or Canadian Institute for Health Information inform pregnant and lactating women of the Pfizer monograph “No data are available yet regarding the use of COMIRNATY Omicron XBB.1.5 during pregnancy” or “No data are available yet regarding the use of COMIRNATY Omicron XBB.1.5 during breast-feeding. It is unknown whether COMIRNATY Omicron XBB.1.5 is excreted in human milk. A risk to the newborns/infants cannot be excluded"; (f) if the answer to (e) is affirmative, how were pregnant and lactating women advised of the Pfizer safety data; (g) what is HC’s scientific basis for claiming safety of the XBB.1.5 mRNA product in P&L women; (h) what rigorous prospective studies, with active patient reporting and monitoring, is HC relying upon to support their safety claims in the P&L population for the use of Omicron XBB.1.5 product?

[Mark Holland, Liberal, Minister of Health]

Mr. Speaker, with regard to part (a), Health Canada’s regulatory evaluation of vaccines includes the review of randomized control studies if there are indications for pregnant and lactating women. Observational studies may be required as part of the risk management plan that is reviewed by Health Canada prior to authorization. In addition, after authorization, Canada has a robust and well-established vaccine safety surveillance system involving Health Canada, Public Health Agency of Canada, PHAC, provinces and territories, and vaccine manufacturers. Health Canada monitors the safety of COVID-19 vaccines through monitoring and risk minimization measures, including requiring manufacturers to regularly submit safety reports and reports of adverse events following immunization, AEFIs, and regularly assessing whether there is any new safety information that may affect the benefit-risk profile of the product. Health Canada has been actively monitoring and reviewing safety data submitted by the manufacturers of the COVID-19 vaccines. Health Canada also monitors and considers information from the scientific literature and international regulators.

With regard to part (b), none of the COVID-19 vaccine manufacturers sought indications for use in pregnant or lactating women or submitted RCTs in pregnant/lactating women for regulatory evaluation. The product monographs included statements about the uncertainties related to pregnancy and lactation. The product monographs can be accessed using the following link: COVID-19 vaccines and treatments portal (canada.ca).

With regard to part (c), as indicated above, there were no RCTs in pregnant/lactating women submitted for regulatory evaluation as the vaccine sponsors did not seek an indication for use in pregnant and lactating women.

With regard to parts (d) and (g), the regulatory basis for the decision taken by Health Canada is publicly available at https://covid-vaccine.canada.ca/ for each specific vaccine. Please see Regulatory Decision Summary and Summary Basis of Decision documents.

As indicated in the specific product monographs, it is noted that the safety and efficacy of these vaccines in pregnant women have not yet been established. No indication for use in pregnant or lactating women was sought by the vaccine sponsors or authorized by Health Canada.

It is important to note that evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy has been growing from real-world use. No safety concerns were identified in a study of more than 35,000 pregnant persons who received an mRNA COVID-19 vaccine during pregnancy or in the immediate period prior to conception. More information about COVID-19 vaccination and pregnancy is available here https://www.canada.ca/en/public-health/services/immunization-vaccines/vaccination-pregnancy-covid-19.html

Health Canada has been actively monitoring and reviewing safety data submitted by the manufacturers as well as adverse events following immunization, AEFI, reported to the Canada vigilance program, CVP, of Health Canada while also considering information from Canadian Adverse Events Following Immunization Surveillance System, CAEFISS, of the Public Health Agency of Canada, PHAC, and foreign data from international partners. Should there be new safety issues identified, Health Canada takes actions, as appropriate.

With regard part (e), Health Canada publishes the product monographs on its website https://covid-vaccine.canada.ca/ in order to inform the public, health care professionals and the research community. As noted in the product monograph, the safety and efficacy of Comirnaty in pregnant women have not yet been established. In addition, Health Canada also publishes the summary basis of decision that provides information about the authorization of the Comirnaty Omicron XBB.1.5. Please see https://covid-vaccine.canada.ca/info/SBD1700495075939-comirnaty-omicron-xbb-1-5-en.html

The National Advisory Committee on Immunization, NACI, is an external advisory body that provides independent, expert advice to PHAC on the optimal use of authorized vaccines in Canada. When making recommendations, NACI considers the benefits and potential risks of a vaccine and any unknowns at the time. NACI has made recommendations for the use of COVID-19 vaccine in pregnant and lactating women based on the totality of evidence available across all authorized COVID-19 vaccines. Considerations specific for pregnant and/or lactating women are included in the Canadian Immunization Guide COVID-19 chapter, which is based on the NACI recommendations. Links to the product monographs for authorized XBB.1.5 vaccines are included in the latest advice from NACI.

With regard to part (f), Health Canada publishes the product monographs on its website https://covid-vaccine.canada.ca/ in order to inform the public, health care professionals and the research community.

With regard to part (h), Health Canada has not approved any safety claims with regard to pregnant and lactating women.

Question No.2167—

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

With regard to the Disability Tax Credit, from 2020 to present, broken down by province and territory: (a) what is the average income for persons who receive the Disability Tax Credit (i) before tax, (ii) after tax; (b) what is the median income for persons who receive the Disability Tax Credit (i) before tax, (ii) after tax?

[Marie-Claude Bibeau, Liberal, Minister of National Revenue]

Mr. Speaker, with respect to the above-noted question, what follows is the response from the Canada Revenue Agency, CRA, for the period of January 1, 2020, to December 13, 2023, the date of the question.

With regard to parts (a) and (b), while the question requests data based on those in receipt of the disability tax credit, DTC, namely certificate holders, the CRA’s DTC income data is structured based on claimants.

The one-to-one relationship between claimants and certificate holders is difficult to ascertain, with the possibility of more than one individual being a claimant on the same certificate. For this reason, CRA is unable to provide the income breakdowns of certificate holders, the beneficiaries, and is not in a position to respond in the manner requested.

The CRA has publicly released detailed statistics on the DTC featuring data on the number of people claiming the DTC, amounts claimed and applications accepted and rejected. This information is available at the following website: https://www.canada.ca/en/revenue-agency/programs/about-canada-revenue-agency-cra/income-statistics-gst-hst-statistics/disability-tax-credit-statistics.html.

This includes data on the number of DTC claimants benefiting through a tax reduction, broken down by net income range. For the most recent such data, please see https://www.canada.ca/content/dam/cra-arc/prog-policy/stats/dtc-stats/dtc-tbl14-2021-e.pdf

Question No.2168—

[Dave Epp, Conservative, Chatham-Kent—Leamington, ON]

With regard to the Interim Order Respecting the Importation, Sale and Advertising of Drugs for Use in Relation to COVID-19 (the Interim Order) on September 16, 2020: (a) does the Minister of Health require an application by the manufacturer to approve a drug that is already approved for another indication; (b) what is the total number of inquiries received by Health Canada and the Public Health Agency of Canada about Ivermectin for the prophylaxis and treatment of COVID- 19; (c) how many inquiries have been made to Health Canada and the Public Health Agency of Canada about Ivermectin for the prophylaxis and treatment of COVID-19, broken down by (i) the general public (ii) healthcare clinicians, (iii) researchers, (iv) provincial and territorial health authorities, (v) hospitals, (vi) long-term care facilities, (vii) healthcare practitioners' regulatory governing bodies, (viii) Members of provincial, territorial and federal Parliament (ix) organizations; and (d) what is the number of signatures on any petitions related to Ivermectin?

[Mark Holland, Liberal, Minister of Health]

Mr. Speaker, with regard to part (a) of the question, yes, the Minister of Health requires a manufacturer to submit an application for approval of a new indication for a drug that is already approved for a different indication. However, health care practitioners may choose to prescribe a drug outside of its approved indication, also called off-label use. Off-label use falls under the “practice of medicine” and is regulated at the provincial and territorial level.

Regarding parts (b) and (c), Health Canada’s bureau of gastroenterology, infection and viral diseases, which is part of the pharmaceutical drugs directorate, received 17 inquiries in its inquiries mailbox related to the use of ivermectin for the prophylaxis and treatment of COVID-19. All inquiries received were from the general public.

In general, inquiries made to Health Canada, or HC, and the Public Health Agency of Canada, or PHAC, about ivermectin for the prophylaxis and treatment of COVID-19 are not systematically tracked in a centralized database. HC and PHAC concluded that producing and validating a comprehensive response to this question would require a manual collection of information that is not possible in the time allotted and could lead to the disclosure of incomplete and misleading information.

However, ministerial correspondence is tracked centrally. Based on the question, 123 pieces of ministerial correspondence were identified and are broken down as follows: 115 pieces from the general public; four from health care professionals; one from a member of provincial, territorial or federal Parliament; and three from organizations.

Regarding part (d), Health Canada and the Public Health Agency of Canada do not track this information.

Question No.2170—

[Kerry-Lynne Findlay, Conservative, South Surrey—White Rock, BC]

With regard to the government’s supply and confidence agreement with the NDP and the associated universal, single payer pharmacare program: what are the government's projected costs to implement this program for 2024 and each of the following five years, broken down by year?

[Mark Holland, Liberal, Minister of Health]

Mr. Speaker, in budget 2022, the Government of Canada committed to continue its ongoing work towards a universal national pharmacare program. This will include tabling a Canada pharmacare bill, and then tasking the Canadian drug agency to develop a national formulary of essential medicines and bulk purchasing plan.

The nature of the bill is still under discussion, and we are not able to confirm either any specific approach to national pharmacare or any potential future investments at this time.

That said, the Government of Canada has made important investments to date to support the implementation of national pharmacare. The government announced its intention to move forward, in partnership with provinces, territories, and other partners and stakeholders, on foundational elements of national pharmacare, including the following.

First is the creation of the Canadian drug agency, or CDA, supported by $89.5 million over five years, in addition to the existing federal funding of $34.2 million annually to support the Canadian Agency for Drugs and Technologies in Health. The CDA will provide the dedicated leadership and coordination needed to make Canada's drug system more sustainable and better prepared for the future, helping Canadians achieve better health outcomes.

Second is the launch of the first-ever national strategy for drugs for rare diseases, supported by investments of up to $1.5 billion over three years. This first phase aims to increase access to and affordability of effective drugs for rare diseases, which will contribute to improving the health of patients across Canada.

Third are enhancements to Prince Edward Island’s public drug programs, supported by $35 million to provide its residents with more affordable access to prescription drugs and to inform next steps on national universal pharmacare.

Question No.2172—

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

With regard to any polling data obtained by the Privy Council Office concerning policies affecting small and medium-sized businesses, since January 1, 2023: what are the details of all polling conducted, including (i) who conducted the poll, (ii) the start and end dates of when the poll was conducted, (iii) the number of participants, (iv) the questions asked, (v) the results of the poll, (v) the value of the contract related to the poll?

[Terry Duguid, Liberal, Parliamentary Secretary to the Prime Minister and Special Advisor for Water]

Mr. Speaker, since January 1, 2023, the Privy Council Office has obtained no polling data concerning policies affecting small and medium-sized businesses.

Question No.2174—

[Don Davies, NDP, Vancouver Kingsway, BC]

With regard to diabetes and analysis done by Health Canada or relevant government departments: (a) does the government have an estimate of the total out-of-pocket costs that people in Canada have to pay on an annual basis if they do not have coverage for (i) prescription diabetes medication, (ii) insulin pumps, continuous glucose monitors and other diabetes control supplies, through public or private insurance?

[Mark Holland, Liberal, Minister of Health]

Mr. Speaker, diabetes is a complex disease with many different treatments, including insulin, metformin and dozens of other medications, which are sometimes used together, to manage blood sugar levels. In addition, diabetics use a range of medical devices, such as syringes and insulin pumps, as well as test strips, continuous glucose monitors and other related supplies to manage their condition.

In general, there are limitations for estimating out-of-pocket costs for people with no public or private insurance. It can be difficult to make generalizations about individual costs as there are considerable variances in dose, frequency, type of medication or supplies and prices, such as in the case of generic or brand name drugs. Some diabetes medications may be used to treat other conditions, and data on the condition for which medication was prescribed is generally not available. Determining the costs for diabetes supplies is especially challenging, as this data is not routinely collected.

While publicly available data on the cost of prescription medications and supplies is limited, Health Canada has licensed access to some data on drug spending in Canada through IQVIA Solutions Canada Inc., which collects data on dispensed prescriptions at retail pharmacies. In 2022, IQVIA data suggests that the combined public, private and out-of-pocket spending on prescription diabetes medications was approximately $4.1 billion. As a disclaimer, the statements, findings, conclusions, views and opinions expressed in this report are based in part on data obtained under licence from IQVIA Solutions Canada Inc. concerning the information services of Compuscript, from January 1, 2022, to December 31, 2022. All rights are reserved. The statements, findings, conclusions, views and opinions expressed herein are not necessarily those of IQVIA Solutions Canada Inc. or any of its affiliated or subsidiary entities.

Diabetes Canada has done work to determine the potential annual out-of-pocket costs for people living with type 1 and type 2 diabetes under different scenarios. Its report suggests that out-of-pocket costs for Canadians living with type 1 diabetes can vary from a low of $78 to a high of $18,306 across the provinces. For type 2 diabetes, out-of-pockets costs can vary from a low of $76 to a high of $10,014. These cost estimates are not broken down with respect to which proportion is for prescription diabetes medication versus diabetes control supplies.

Question No.2178—

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

With regard to any polling data obtained by the Privy Council office concerning anti-scab legislation or replacement workers, since January 1, 2023: (a) what are the details of all polling conducted, including (i) who conducted the poll, (ii) the start and end dates of when the poll was conducted, (iii) the number of participants, (iv) the questions asked, (v) the results of the poll, (vi) the value of the contract related to the poll?

[Terry Duguid, Liberal, Parliamentary Secretary to the Prime Minister and Special Advisor for Water]

Mr. Speaker, since January 1, 2023, the Privy Council Office has obtained no polling data concerning anti-scab legislation or replacement workers.

Question No.2179—

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

With regard to any polling data obtained by the Privy Council Office concerning electoral reform, since January 1, 2023: (a) what are the details of all polling conducted, including (i) who conducted the poll, (ii) the start and end dates of when the poll was conducted, (iii) the number of participants, (iv) the questions asked, (v) the results of the poll, (vi) the value of the contract related to the poll?

[Terry Duguid, Liberal, Parliamentary Secretary to the Prime Minister and Special Advisor for Water]

Mr. Speaker, since January 1, 2023, the Privy Council Office has obtained no polling data concerning electoral reform.

Question No.2183—

[Carol Hughes, NDP, Algoma—Manitoulin—Kapuskasing, ON]

With regard to the Wahpeton New School Project proposal, since January 2023: (a) what meetings and consultations have the Minister for Crown-Indigenous Relations and the Minister for Indigenous Services had regarding the need for a new community school; (b) what services has the department offered to help Wahpeton with funding, planning, and completion of a new community school; (c) what interim measures has the government provided to Wahpeton Dakota Nation to ensure students can continue in-class learning; (d) does the government intend to fund and complete a new community school in Wahpeton; (e) for what reasons has the government not proceeded with this project; and (f) by what date does the government expect construction to begin on a new community school?

[Jenica Atwin, Liberal, Parliamentary Secretary to the Minister of Indigenous Services]

Mr. Speaker, the Minister of Crown-Indigenous Relations and Northern Affairs has nothing to report on this issue.

With regard to part (a), Indigenous Services Canada, ISC, officials have been directly involved with Wahpeton Dakota Nation’s project management team to support and assist the community in the preplanning, design and construction of a new school facility.

With regard to part (b), a new school for Wahpeton Dakota Nation is in the design stages. ISC is working with the community to ensure that the new school will meet the most current, recently updated standards in space allocation, building construction, education delivery, cultural and outdoor learning and proper learning environments to accommodate all students, including those with high needs.

With regard to part (c), portable classrooms were provided in an effort to remove students from the conditions that existed in the original building. Subsequent replacement of two of the original portable classrooms that were beyond repair is currently ongoing.

With regard to part (d), ISC is committed to successfully moving this project to tender and construction.

With regard to part (e), budgetary constraints, volatility in the construction market and a redesign due to changes in the school space accommodation standards have contributed to the delay in construction. Most recently, changes in the school space accommodation standards resulted in beneficial eligibility for the community to increase space allocations beyond the original design. The positive impact of the redesign provides long-term improvements to the educational spaces.

With regard to part (f), the new school may proceed to tendering and construction upon completion of planning and preconstruction project phases. The project management team estimates the redesign, with refined enrollment projections and additional space allocation through the updated school space accommodation standards, will be complete and ready for tender in November 2024.

Question No.2184—

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

With regard to the government’s agreement with Stellantis-LG Energy Solutions (LGES) related to electric vehicle battery production: (a) were any consultants or external advisors used by the government related to the deal or the negotiations, and, if so, what are the details of each, including (i) who, (ii) the amount of the contract, if applicable, (iii) the description of goods or services provided, (iv) the reason that the consultant or advisor was chosen; and (b) were any bonuses or performance awards awarded to any individuals for their work on the agreement, and, if so, (i) how many people received such bonuses or performance awards, (ii) what was the total amount paid out in such bonuses or performance awards?