Health committee  If I were to design a program like this, I would start with the most compelling evidence-based basket of medicines that should be provided. You've heard witnesses testify that some of those compelling medicines, including GLP-1 drugs, such as Ozempic, are outside of the current proposed basket, so you might go back and think carefully about what would be included.

Health committee  One of the things is that if we move to a system that is truly national, universal and single-payer, Canadians will have increased access to medicines from coast to coast. We can use national procurement contracts to get better prices for medicines. We can use those same contracts to make sure manufacturers guarantee the supply of medicines when Canadians need them and when we know shortages are all too common internationally.

Health committee  —and it would deliver savings to the private sector of $1.7 billion per year and net savings to the country of $700 million.

Health committee  This plan will provide some new coverage, but it will cost significantly more than it should and will continue to impose inequitable financial burdens on individual households and employers.

Health committee  They're not better. There's no change. That's what the minister basically said yesterday in testimony. They'll just have the same coverage through their private insurance under this new plan. What we want to see is a change where they can actually see their medicines being procured nationally through a public program that takes the financial burden off their households and their employers.

Health committee  That's not what this bill will achieve.

Health committee  Yes, I'll be quick. There are minor amendments to clauses 4 and 6 of Bill C-64 that would probably suffice to make sure that even though this is just like baby steps, the pilot project for implementing Hoskins' recommendations, if you make a couple of key amendments, you can genuinely say that this legislation is actually going to do what Hoskins said.

Health committee  I think what you do is build national capacity to procure, with ironclad contracts with manufacturers, medicines of proven safety, efficacy and value. Essentially, we need to implement the recommendations of the Hoskins council.

Health committee  Yes, alongside other primary care providers.

Health committee  No, other than to say that this has been thoroughly studied, and the business case for making sure we have universal access to appropriately prescribed medications is unequivocal. It is good for the country's health. It's good for the health care system.

Health committee  I have a couple of points. I'm glad you raised the issue around timeliness in terms of drug approvals and coverage decisions. Some of the evidence that's been cited in testimony in these hearings comes from reports that start the clock, so to speak, when a medicine is first approved in any country internationally.

Health committee  I was not directly involved in developing this piece of legislation or the bill at all. I've worked with government and advised different people within the bureaucracy and government over many years, but I was not involved in drafting Bill C-64.

Health committee  Thank you. I'm an economist and professor of health care policy who has studied pharmacare systems for 30 years. I have published over 150 peer-reviewed research papers on related topics, and I serve on the World Health Organization's technical advisory group on pricing policies for medicines.

Health committee  You've bundled a couple of questions. I appreciate that, because I literally have to run after responding to this. PMPRB's net-after-rebate price restrictions on economic analyses would not necessarily disclose the final prices in Canada, because it sets a maximum price that the manufacturer could ask payers in Canada to pay.

Health committee  Yes, absolutely. The idea of having a patent as a mechanism for incentivizing research and development typically comes from markets where the price that a consumer is willing to pay is based on the idea that the consumer can always walk away from a transaction on a voluntary basis and not be harmed unduly by doing so.