Health committee  We'll take that back and we'll see what we can provide.

Health committee  I'll just say that over the years, in terms of the adverse-reaction reports, they have been increasing. If you look at the last two years, we've had about 1,000 in the two-year period, with over 700 of them being serious, so they are increasing. We have more products, so it's understandable that we'll have more reports.

Health committee  That's a good question. In terms of the products that have been authorized, there would be over 200,000 products. However, we believe that potentially only half of those are marketed. There's no requirement for companies to notify Health Canada if they're marketing the products, so we don't really have that number.

Health committee  For pharmaceutical drugs, prescription drugs, we do have higher levels. It's in the tens of thousands. We also have a requirement for increased reporting under Vanessa's Law. We have the requirements for health institutions to be reporting those adverse events as well. That's already shown an increase in reports.

Health committee  In doing surveillance of the products once they're on the market, one of the inputs into that is the adverse reactions that get reported to Health Canada. We know those are vastly under-reported for all products. We know they're even more under-reported for natural health products.

Health committee  Before 2004, it did not happen. Before we put the national health products regulations in, we did not have a premarket system, so before products were on the market, they weren't being reviewed. We have that now. Actually, that is one part of the system—whether it's been the OAG or others who have looked at it—that is said to be running well.

Health committee  Yes. The idea is that for these products, the level of evidence that's required should match the type of product it is and what it's being used for. I will say that through the self-care framework, which was launched in 2018, we have also introduced classes of products based on the ingredients and whether or not there's something called a monograph there.

Health committee  If you're saying from 2004 to 2021, we've had over 8,000 adverse reactions reported in which the natural health product use had a suspected role, and over 5,000 of those were labelled as serious. A serious adverse reaction is something that either causes you to be admitted to hospital or prolongs a hospital stay.

Health committee  That's available in the Health Canada database. We actually put those out publicly. We've done that and compiled those numbers. You would have to do a search for “adverse events” and “natural health products”.

Health committee  We can provide the reference. Again, this is publicly available information, but we can provide that.

Health committee  The short answer is they're not complaining, because it's not in effect yet, that specific provision under Vanessa's Law. Under the Vanessa's Law provisions, some have come into effect already. For example, there's the ability to compel a recall of a product. I think people were surprised to know that before June 2023, we could recall a head of lettuce but we didn't have the authority to compel a recall of a natural health product.

Health committee  We're very concerned about small and medium-sized businesses. We know they're the backbone of the economy and they want to have products for Canadians that are safe and effective. That's why we have fee mitigation for those small businesses, such as decreases of 25% to 50% in costs for small companies, and if it's their first submission there would be a complete fee waiver.

Health committee  That's part of the proposal. There's a definition for qualifying small businesses, so they can qualify for a reduction in fees of between 25% to 50%, and again, for their first submission the fees are waived completely.

Health committee  I said that is part of the current proposal. No fees have been put in place at this point in time. It's just a proposal that's been out for consultation, and that's closed. The proposed fee mitigation was between 25% to 50%, but if we get comments that are different, then that could potentially change.

Health committee  We received 4,700 comments. The consultation period just closed. I will say, though, that in those comments there are a lot that simply say, “We do not want to pay fees at all.” Only about one per cent to three per cent of all the comments were constructive suggestions on how to change the framework or the cost recovery fee structure.