Pharmaceutical: The Last Six Months
Of Federal Activity

About

This Report

This is a computer-generated report that shows all of the federal activity with respect to the keyword "Pharmaceutical" over the last six months. This is a demonstration of the power of our government relations automation software.

Hansard

House: 62 Speeches
Senate: 9 Speeches

House Senate

Bills

Active: 0

Regulations

Filed: 0
Proposed: 0

The House

Ms. Leona Alleslev (Aurora—Oak Ridges—Richmond Hill, Lib.)

November 27th
Hansard Link

Statements by Members

“...software to help the visually impaired learn to read Braille, to a man who developed technology for pharmaceutical molecular structures, to a world-renowned film director, to the first Canadian circum...”

Mr. Nathan Cullen (Skeena—Bulkley Valley, NDP)

November 23rd
Hansard Link

Business of Supply

“...of dollars of shares. That seems wrong. If the health minister introduced a bill while still owning pharmaceutical shares worth tens of millions of dollars that helped out that pharmaceutical company, we would scream foul. The finance minister gets up day after day and says th...”

Mr. Lloyd Longfield (Guelph, Lib.)

November 8th
Hansard Link

Government Orders

“.... Through budget 2017, we are investing over $140 million over five years to help improve access to pharmaceuticals and support innovations within the health care system, but we know there is a lot mo...”

Mr. Bill Blair (Parliamentary Secretary to the Minister of Justice and Attorney General of Canada and to the Minister of Health, Lib.)

October 27th
Hansard Link

Oral Questions

“...ing those prices down. We have joined the provinces and territories as a member of the pan-Canadian Pharmaceutical Alliance, which negotiates lower drug prices on behalf of public drug plans.

Through budget 2017, we have invested over $140 million to help improve access to pharmaceuticals and to support innovation within the health care system. These are the actions that ...”

Mr. Darren Fisher

October 27th
Hansard Link

Private Members' Business

“...the-clock care. Many folks with sickle cell are receiving regular blood transfusions and are taking pharmaceuticals to manage chronic pain. Numerous blood transfusions are not uncommon for someone wit...”

Mr. Guy Caron (Rimouski-Neigette—Témiscouata—Les Basques, NDP)

October 25th
Hansard Link

Oral Questions

“...y, he would be in a conflict of interest. If the Minister of Health had a controlling interest in a pharmaceutical company, she would be in a conflict of interest. If the Minister of Natural Resources...”

Hon. Jim Carr (Minister of Natural Resources, Lib.)

October 19th
Hansard Link

Business of Supply

“...crude oil of the future, with biofuels substituting for fossil fuels in the production of plastics, pharmaceuticals, and chemicals.

Then there is wood as a building material. Pound for pound, en...”

Ms. Elizabeth May (Saanich—Gulf Islands, GP)

October 18th
Hansard Link

Routine Proceedings

“...are where that universal health care plan does not include guaranteed access to medically necessary pharmaceuticals.”

Hon. Ginette Petitpas Taylor (Minister of Health, Lib.)

October 17th
Hansard Link

Oral Questions

“...ed for a national formulary. We joined the provinces and territories as members of the pan-Canadian Pharmaceutical Alliance. Also, in budget 2017 we are investing over $140 million to help improve access to pharmaceuticals.

These actions will save Canadians money as we continue to work with provinces...”

Mr. Don Davies (Vancouver Kingsway, NDP)

October 5th
Hansard Link

Business of Supply

“...ls on the government to take action to address one of the most pressing and solvable of these gaps: pharmaceutical drugs.

Currently, this gap consists of a patchwork of private and public coverage that varies widely across Canada. Outside of Quebec, every province and territory provides public drug coverage for people only in very limited circumstances, sometimes for those on social assistance, sometimes for seniors, and sometimes for people with specific conditions such as cancer, transplants, and infectious diseases. For those outside these groups, folks have to pay the cost of the medication out of their own pockets.

Quebec is the only province with a mandatory program, requiring that every citizen obtain insurance. However, it is a mixed private-public scheme where the most expensive and difficult-to-insure citizens are foisted onto the public plan, making it extremely costly. The situation is problematic even for those who have extended benefit plans through work. These plans often have annual limits or copayments that leave claimants exposed for out-of-pocket costs. Employers across Canada report difficulty paying for these benefits and increasingly are dropping coverage for their employees.

The consequences of this omission are present in every community and every demographic. They are real. They are pressing. They are serious.

Here is a typical example, recently described in an article written by two physicians from Alberta. They describe the real case of a 60-year-old Calgary woman with high blood sugars and very high blood pressure. She paid for medications out of her own pocket each month, she had no employer insurance, and she could not afford the premium for Blue Cross. One month, however, when facing extra expenses, she did not have enough money to pay for her expensive diabetes and blood pressure medications. She ended up in the hospital. This woman would likely have avoided the emergency room altogether if she had stayed on her medications. Ironically, by having to access hospital care, she ended up costing our health care system much more than the cost of her medication.

Unfortunately, stories like hers are all too common. A number of studies have established that 10% to 20% of Canadians have no pharmaceutical coverage whatsoever. This means that four million to seven and a half million Canadians are living every day without the medicine their own doctors prescribe for them and which they need to stay healthy and sometimes even alive. One in five Canadians reports that he or she or a family member neglects to fill prescriptions due to cost. In fact, Canada has the second-highest rate of skipped prescriptions among comparable countries. This particularly hurts seniors and the poor. One in 12 Canadians over 55 skips prescriptions due to cost. Low-income Canadians are three times more likely to experience financial barriers to accessing essential medication.

Shamefully, Canada stands virtually alone among developed countries in this regard. We have been identified as the only developed country in the world with a universal health care system that does not provide some sort of universal prescription coverage. Canada is one of only five OECD nations whose public health system does not provide publicly funded drug insurance to all citizens. Even as millions go without coverage, Canadians pay among the highest prescription drug prices in the industrial world, second only to the U.S., and these costs are growing at an alarming rate.

Here is the absurdity. If someone cuts a finger, he or she goes to the doctor who stitches it up, and the individual leaves and never sees a bill. However, if people go to a doctor and their ailment needs to be treated by medication, they are at the mercy of their ability to pay. This is irrational, it is unfair, it is not consistent with a modern universal health care system, and it is also unnecessarily expensive.

However, there is a solution. In fact, it is a solution so clear, so established, and so patently feasible that there is no reason why we should not begin to implement it at once. That is what this motion and the New Democrats are urging the government to do; to begin to implement a universal pharmacare system in Canada. (1015)

By implementing a universal public pharmacare system, we can cover every single Canadian, every man, woman, and child, and save anywhere between $4 billion and $13 billion a year. Let me repeat that, just as with universal health care, we can make sure that all Canadians can get the necessary medicine they need when they need it and we can collectively save billions of dollars as a nation. Here is how and why.

A universal public system would save money in myriad ways. It would establish a national, independently monitored, evidence-based formulary that covers drugs that are the most effective and cost sensitive. It is estimated that more than $5 billion a year is wasted because private drug plans pay for unnecessarily expensive drugs and dispensing fees. By reimbursing drugs only when they represent value for money, public plans are much better equipped to rein in such costs.

Second, it would allow for the effective national bulk purchasing of drugs, a proven method that reduces drug costs by an average of 40% for brand-name drugs, as has been the experience in New Zealand, the U.S. veterans administration, and countries throughout Europe. A year's supply of atorvastatin, a widely used cholesterol drug, costs about $143 in Canada, but only $27 in Sweden and $15 in New Zealand.

It would allow for the negotiation of exclusive licensing agreements with pharmaceutical companies to achieve the best prices for widely used medications. It would streamline administration costs, reducing thousands of duplicative administrative systems, perhaps to one per province and territory. The administration costs of for-profit private plans average 15%, while administration costs for public plans are less than 2%.

It would avoid cost-related non-adherence, the technical term for the increased costs that come when folks do not take their medicine and become more seriously ill. The health committee heard evidence that one diabetic patient who ends up in intensive care because that individual could not afford to take insulin costs more money than providing free medication for life.

However, members do not have to take my word for it. The parliamentary budget officer's report on the federal costs of a national pharmacare program, released September 28, confirms what health policy experts have been saying for years, that Canadians could have a pharmacare system that covers everyone for billions of dollars less than they now pay for prescriptions. The PBO found that, in 2015, Canadians spent $24.6 billion on pharmaceuticals that would have been eligible for coverage under a national pharmacare plan. Account...”

Mr. Don Davies

October 5th
Hansard Link

Business of Supply

“...n for the members of this House. The parliamentary budget officer said that we spent $28 billion on pharmaceuticals in this country in 2015-2016, and then he took out about $4 billion of that because that was extra private coverage that would not be covered under a pharmacare system. He is saying that we paid $24 billion for drugs that would be covered under a national pharmacare program, using the Quebec formulary. He ran the numbers, using conservative estimates, and found that if we had a national pharmacare program we would have paid $20 billion.

The last time I checked, $20 billion is less than $24 billion. I would rather pay $20 billion in this country for pharmaceuticals and cover everybody than pay $24 billion and leave 20% of Canadians not covered. The citizens of this country are the ones who are going to pay for it. Whether their dollar or employer pays it to the pharmaceutical companies or whether it is paid to the government that administers the program, it do...”

Hon. Ginette Petitpas Taylor (Minister of Health, Lib.)

October 5th
Hansard Link

Business of Supply

“...ent care, others do little to improve health outcomes. Therefore, stronger management of our use of pharmaceuticals is essential, and the cost demonstrates this. Every year across the system pharmaceuticals account for an ever greater share of health spending in the country. In 2014, drug spending reached $29 billion. That represented about 16% of our health spending. When we add up drug spending for 2016, we expect that amount to grow to about $36 billion a year. That is a significant number.

Clearly, pharmaceuticals play an increasingly important part in Canada's health care system. Unfortunately, even as public and private payers wrestle with the growing costs, Canadians are not getting all of the benefits that this level of investment should provide to them. A key reason for this is that Canadian prices for both patented and generic drugs are high by international standards.

Our patented drug prices are exceeded only by the U.S. and Germany, and we are well above the average for the 35 countries of the OECD. According to the most recent data available, in 2015, OECD generic drug prices were, on average, 28% lower than those in Canada.

There are some other factors that feed the challenges we face in managing the use of pharmaceuticals within this country. For example, Canada's drug review and approval system, which includes federal regulatory review for quality, safety, and efficiencies to determine if a drug should be authorized for sale in Canada, followed by a review of cost-effectiveness by the Canadian Agency for Drugs and Technologies in Health, is cumbersome and needs to be revised.[Translation]

This system lacks the flexibility to meet patients' needs in a timely manner. These concerns need to be addressed before we can start to consider any expansion to the pharmacare program. That is why our government is tackling these challenges by taking action to improve the affordability, accessibility and appropriate use of prescription drugs for Canadians.

The last federal budget, which was tabled in 2017, supported these actions with an investment of $140 million over 5 years, followed by $18.2 million per year on an ongoing basis. This funding supports the work of Health Canada, the Patented Medicine Prices Review Board, and the Canadian Agency for Drugs and Technologies in Health. In collaboration with pan-Canadian health organizations and our provincial and territorial counterparts, we will work to lower the cost of prescription drugs, provide faster access to new drugs that Canadians need, and improve patient care through more appropriate prescribing practices.[English]

To better protect Canadian consumers and public and private drug plans from excessive patented drug prices, our government is modernizing the way prices are regulated. For the first time in more than 20 years, the Minister of Health will update the patented medicine regulations, which, together with relevant provisions of the Patent Act, provide the PMPRB with the tools and information it needs to monitor and regulate prices in today's pharmaceutical environment.[Translation]

At the end of June, Health Canada held its first round of public consultations on potential changes. Stakeholders and all interested Canadians will have another opportunity to comment once the regulatory changes are published in Part I of the Canada Gazette later this year. The Government of Canada is also working closely with the provinces and territories to reduce the country's drug costs. (1050) [English]

In addition, the Government of Canada is working closely with the provinces and territories to reduce drug costs. As a member of the pan-Canadian Pharmaceutical Alliance, established by the provinces in 2010, we are combining the collective purchasing power of all public drug plans in Canada to make prescription drug prices more affordable and to lower generic prices for all payers.

This initiative has been extraordinarily successful. As of March 2017, the work of the alliance has resulted in annual savings of almost $1.3 billion.[Translation]

Our government also recognizes the importance of supporting breakthrough innovation and giving Canadians quicker access to the new medications they need while continuing to ensure the quality and effectiveness of those drugs. That is why Health Canada launched a new five-year initiative to make the minister a more modern, flexible, and responsive regulator. Under this initiative, the government will harmonize federal medical review procedures with those of its health care partners, such as CADTH. Jointly implementing these programs will speed up decisions about adding new drugs to the list of insured drugs, which means that useful new treatments will be available to Canadians sooner.

In addition, Health Canada will expand its priority review policy and establish new regulatory pathways to expedite the consideration of new drugs that have the potential to meet the pressing needs of patients in the health care system.

The initiative will also see the expanded use of real-world evidence about new drugs after they enter the market. This will ensure that they are as safe and effective as expected and will allow the government to take action if a problem is identified.

Finally, our government will work collaboratively with health system partners to improve the quality and efficiency of patient care through more appropriate prescribing practices. With enhanced federal support, CADTH will develop improved prescribing tools and provide health care practitioners with guidance on the optimal use of drugs and drug products.

All these measures combined will have major repercussions and will make drugs more affordable and more accessible while ensuring the appropriate use of prescription drugs. They will help advance the common interests of the federal, provincial, and territorial governments by improving Canada’s pharmaceuticals management system to ensure that it is sustainable and meets the needs of Canadians....”

Mr. Don Davies (Vancouver Kingsway, NDP)

October 5th
Hansard Link

Business of Supply

“...health care professional in the country who has studied this issue: seven million Canadians have no pharmaceutical coverage whatsoever today. That means that there is someone waking up in this country...”

Mr. Kevin Lamoureux (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.)

October 5th
Hansard Link

Business of Supply

“...n I think of the pharmacare file, obviously all of our constituents are concerned about the cost of pharmaceuticals and getting the medicines they require. The work the government has done in getting ...”

Mr. Don Davies

October 5th
Hansard Link

Business of Supply

“... would not understand that.

The issue here is not only that Canadians are paying too much for pharmaceuticals, but that millions of Canadians do not have coverage at all at any cost. Therefore, ...”

Hon. Ginette Petitpas Taylor

October 5th
Hansard Link

Business of Supply

“...ealth Infoway, a pan-Canadian organization that has done some very innovative work when it comes to pharmaceuticals. It is looking into a digital system to ensure that when doctors are prescribing dru...”

Mrs. Stephanie Kusie (Calgary Midnapore, CPC)

October 5th
Hansard Link

Business of Supply

“...As we consider this motion, we should be aware that the principal role of the federal government in pharmaceuticals, according to the parliamentary budget officer's report, is to regulate market access, thereby ensuring the efficacy, quality, and safety of drugs; to provide financial support to the provinces through the Canada health transfer, as required by the Canada Health Act; to deliver pharmaceuticals to particular populations; and to regulate the price of new and innovative drugs.

The Standing Committee on Health is currently studying the possibility of a national pharmacare system. In fact, it was that committee that requested a report by the parliamentary budget officer on the potential costs involved. The completed study was provided to the committee just last week. Given this, I would suggest that the opposition day motion is a bit poorly timed. Does it not make sense for the committee to now have time to examine the report, consider its findings, and then report back to the House? I would ask the member for Vancouver Kingsway, the vice-chair of the health committee, to provide his committee colleagues the time they need to do their job.

The Conservative Party of Canada wants to ensure that Canadians are receiving the best health care possible and that even the most vulnerable have access to the latest in pharmaceutical care. As we know, the Canada Health Act provides universal drug coverage for prescription drugs administered in a hospital setting. In addition, the federal, provincial and territorial governments all offer drug insurance plans, providing some coverage to approximately 53% of the Canadian population. If we are to consider an additional level of coverage, we need to bear in mind that private drug insurance programs provide coverage to 24 million Canadians in total.

I think we should focus on the result of a 2002 study by the Fraser Group that estimated that 11% of Canadians faced the risk of high prescription drug costs because they either had no coverage at all, or were significantly under-insured. These are the Canadians who need this type of program. Therefore, I would suggest that a more targeted approach would be to begin with the health committee's study on a national pharmacare program.

Let us look at the costs, the logistics, and the overall effect of a program focused on Canadians currently without any existing coverage at all. This would include seniors, those with low fixed incomes, people with uncertain work or low wage jobs without benefits, the disabled and others in need. Should the committee and the House agree to examine a plan like this, we could receive feedback from the provinces, stakeholders and, indeed, from Canadians themselves on whether it would indeed provide quality health care to those in need of it. Additionally, the information obtained on the actual versus estimated costs would be invaluable for future discussions of a possible and potentially expanded program.

This brings me to the fact that my Conservative colleagues and I are concerned about the lack of data and the high initial cost of implementing a national pharmacare program here in Canada, considering the growing deficits that Canadians are facing as a result of the irresponsible government. This motion unfortunately reflects what I would describe as typical NDP thinking. The members somehow believe that there is an unending supply of tax dollars that can be accessed into infinity. (1110)

The PBO has evaluated what it would cost to provide a national pharmacare program to all Canadians, even those with an existing plan, to be approximately $22.6 billion dollars annually. The PBO indicated that its initial study shows that a national program would grow by 11% in just five years, from $19.3 billion to $22.6 billion in 2020. It also clarified that this number could be off quite substantially, as overall consumption of prescription medication could very well increase under a national pharmacare plan. The cost of prescription medications is the largest factor causing patients not to follow their prescribed treatments, and with the sudden implementation of a universal pharmacare program, individuals with newfound access could end up flooding the system. These costs are unpredictable.

Although the parliamentary budget officer provided a budget based on the drugs list in Quebec, the drugs on that list are quite different from other provinces', which is another factor making the true costs unknown. The health needs of each province's population, prescribing habits of physicians, generic drug pricing, and price negotiations vary. This creates differences in the consumption by and even coverage of various drugs for specific populations. To seriously consider pharmacare, we must determine the potential source of the funds, particularly as the current government has well exceeded its proposed deficit targets, leaving us with little room to consider this plan.

The Conservative Party of Canada supports a high-quality, sustainable health care system that would ensure that Canadians get the best possible care. As previously mentioned, approximately 12% of Canadians are under-insured or not covered by a plan already. Due to the fact that the majority of people are already covered, we should be targeting our limited resources at a more efficient way of covering individuals who do not presently have coverage. This would involve focusing on individuals such as seniors, those with low fixed incomes, people with uncertain work or low-wage jobs without benefits, the disabled, and others in need.

The fact is that there are alternatives to reduce the costs for Canadians, especially those without drug coverage, as I discussed recently with regard to Motion No. 132. Costs can be lowered through volume leveraging and generic-versus-brand purchases without the scope of a program, as costed by the parliamentary budget officer. The resulting savings could be upwards of $7 billion.

Again, I would remind the House that the framework of the parliamentary budget officer's report on funding health care is based on Quebec's inclusive list of drugs, eligibility requirements, copayment levels, and eligibility requirements for copayment exemptions. It is important to note, however, that Quebec runs a hybrid system that is close to universal pharmacare by requiring that residents have drug coverage either through a private plan sponsored by their employer, a professional association, or through the government-run public plan. Even in that province, 7.2% still do not adhere to prescribed treatment due to the cost.

I would suggest that the health committee look at how my home province of Alberta is handling this issue. Alberta works hard at providing publicly funded drugs to those who need them the most, such as seniors. It provides public drug coverage plans for individuals who have no other type of coverage and who are not necessarily experiencing high drug costs relative to their income. There, the the number of people who do not adhere to their drug treatment plans due to the cost is only 0.4% higher than in Quebec. However, the key point is that with similar results to Quebec, Alberta is able to do so at $209 billion lower cost.

In summary, while no Canadian should be without necessary pharmaceuticals, we must consider the most efficient and cost-effective way to achieve this. I would...”

Mr. Don Davies (Vancouver Kingsway, NDP)

October 5th
Hansard Link

Business of Supply

“...xpensive. It is a cost of business for them to provide those benefits to their employees, and since pharmaceuticals are among the fastest-rising costs in the health care system, they are finding it ve...”

Mr. Kevin Lamoureux (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.)

October 5th
Hansard Link

Business of Supply

“... Manitoba. There was a great debate even at that time on how to address the ever-increasing cost of pharmaceuticals. One of the discussions we had was on the fact that we had two tertiary hospitals, w...”

Mrs. Stephanie Kusie

October 5th
Hansard Link

Business of Supply

“...are being put in at present.

While I would agree that we all share the objective of universal pharmaceutical coverage in one capacity or another, when it comes to spending, I and the Conservativ...”

Mr. Don Davies (Vancouver Kingsway, NDP)

October 5th
Hansard Link

Business of Supply

“...going to vote against a motion that would bring in a system that would actually reduce the costs of pharmaceuticals for every single Canadian in this country? Why does he want to saddle them with higher pharmaceutical costs?”

Mr. Kevin Lamoureux (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.)

October 5th
Hansard Link

Business of Supply

“Mr. Speaker, it has been an interesting discussion. When we talk about the cost of pharmaceuticals, the NDP says it is a $20 billion cost commitment, and I wonder if we could discuss ...”

Ms. Rachel Blaney (North Island—Powell River, NDP)

October 5th
Hansard Link

Business of Supply

“...d by pharmacare.

The PBO costing found out that, in 2015-16, Canadians spent $28.5 billion on pharmaceuticals. Of this, $24.6 billion would have been eligible for coverage under a national pharm...”

Mr. Kevin Lamoureux (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.)

October 5th
Hansard Link

Business of Supply

“... through the Department of Health, has assisted in providing that pan-Canadian agreement working on pharmaceuticals.

We have been in government for close to two years. The NDP is trying to give ...”

Mr. Bill Casey (Cumberland—Colchester, Lib.)

October 5th
Hansard Link

Business of Supply

“... Canada. They have secret deals with each other and all these things. I was amazed to learn how the pharmaceutical system works in Canada. It is very hard to get straight answers on how it works, but a national pharmacare program would eliminate all of that.

There are about 100 or so different pharmacare programs already in Canada. The provinces each have one for seniors. They have one for disabilities. They have one for social services. They have one for their own employees. The RCMP has one on the federal side. The military has a pharmacare program. The government has one for indigenous people. There is a plethora of pharmacare programs. They are all different. They all take management. They all require overhead. One pharmacare program would eliminate all those different agencies. We would have one consistent program across the country. Everyone could have access to pharmacare.

I am leaning toward a pharmacare program myself, but we are not there yet. We still have a lot to learn. Our job as a committee, as the original decision said, is to report the findings to the House when we are done our study. We are not done the study. There are so many questions.

We asked the parliamentary budget officer to do this, and it took him many months to do it. We have been at it for almost two years. Again, we have had 89 witnesses and 20 meetings, and we are still learning a lot as we go. The parliamentary budget officer came back a couple of times and asked for clarification on what he should use for formularies and a structure. We are very grateful to him and his team for doing the work. However, we still have to finish our work. We have not finished our work. Part of that work is to interview him and find the answers to some of the questions we have. I am sure he cannot answer them all yet, because we did not give him a model to use. (1210)

We talk about saving billions of dollars, but it is going to cost other organizations and levels of government billions of dollars, so we have to figure out the proper model before we start negotiations. We cannot go into negotiations not knowing what we are talking about or having a model to work with.

The Standing Committee on Health has been almost two years at this now, and we are still hearing from witnesses. We have witnesses coming the week after next. We have heard from patient advocates. We have heard from experts in medicine, social policy, and constitutional law. That is an issue we have not touched on here. The parliamentary budget officer has not touched on it either, because it is not his jurisdiction, but there are constitutional issues in creating a national pharmacare program. What are the responsibilities of the provinces? What are the responsibilities of the federal government? Where do they fit, and how can we work that out? We have to start with a model, and we do not even have an idea of a model yet.

There is a process, and we are only partway through it. The committee, in the end, is going to make a recommendation to the government, and the government will decide. We are not even ready. The member who proposed this is a member of that committee. He has kind of jumped the process to get ahead of us, which is what the motion is asking us to do. It is asking us to not complete the study we all agreed to do. He wants us to go ahead with just part of the information. It is a contradiction. It does not make sense.

I admire the member's work and his intention. Certainly the testimony we have heard has been very compassionate and compelling, but we are not there yet. Our own committee is not ready to make a recommendation, so I do not know how the government could go ahead and start a process to negotiate, without the committee, of which he is a member, coming to conclusions on how we are going to do this and developing a model.

There is no question that we have heard compelling evidence, and all the arguments for it are really good. It is amazing to sit through the testimony we have heard about our health care system.

Again, I go back to the purpose of the study we started. The reason we are debating this motion today is that it came up in our committee meeting. We proposed in our committee to have the parliamentary budget officer do this budget. We proposed it as part of the process, so we now have that. It is valuable. It has given us a lot of information, but there are many questions about who would be responsible for what areas, and we do not have those answers.

Some people say it is not even constitutionally possible. We have to nail that down. We have to get a better idea of who is going to be responsible and what jurisdiction is what. Are we going to bring it in slowly? Are we going to phase it in or bring it in with a big bang? Both have been recommended to us, but we have not come to a conclusion yet, because we have not finished our meetings.

The Canadian Agency for Drugs and Technologies in Health has a role to play. We need to hear from it. The Patented Medicine Prices Review Board will have a say in this, because pricing is everything. Part of the PBO report is based on a significant discount based on volume-buying for the whole nation, one buyer for the whole nation, effectively. We have to confirm that this discount is actually real. Right now the pan-Canadian Pharmaceutical Alliance gets a discount. We have to confirm with the alliance that this could be app...”

Mr. Don Davies (Vancouver Kingsway, NDP)

October 5th
Hansard Link

Business of Supply

“...ow, and I do not think the government can deny it, that there are millions of Canadians who have no pharmaceutical coverage whatsoever and that their health is deteriorating as a result.

Second, we know that a universal pharmacare system would save billions of dollars. We know this from the report by the PBO and from every other report by academic researchers referred to at committee, which have shown that we would save billions of dollars. We wanted to confirm those other reports by an objective, independent study by the parliamentary budget officer. He tabled that report last week. His conclusions, using conservative assumptions, leaving out cost-saving measures, and using the broadest formulary in the country, Quebec's, were that we would save $4.2 billion.

I do not hear anyone on the government side denying any of that. However, what I hear them saying is that we do not have the details. That is what the motion calls for, for the federal government to sit down with the provinces over the next year to work out those details.

I must say that it was complex to bring in universal health care in this country. We did it in the 1960s. What differences does the member see between that and the federal government's working with the provinces to extend universal coverage to pharmaceuticals? Why is that unconstitutional or complex, when we have already done it with health c...”

Mr. Ken Hardie (Fleetwood—Port Kells, Lib.)

October 5th
Hansard Link

Business of Supply

“...the people who do not have coverage, who are having to make some difficult choices in procuring the pharmaceuticals they need to maintain a quality of life and hopefully recover in regard to some thin...”

Ms. Sonia Sidhu (Brampton South, Lib.)

October 5th
Hansard Link

Business of Supply

“... information to health care decision-makers across Canada about the effectiveness and efficiency of pharmaceuticals, medical devices, diagnostics, and procedures.

CADTH has helped Canada become ...”

Mr. Peter Julian (New Westminster—Burnaby, NDP)

October 5th
Hansard Link

Business of Supply

“...reds of thousands of Canadians, including thousands in the Brampton area, who do not have access to pharmaceutical products that would keep them healthy and alive. For the life of me, I cannot underst...”

Ms. Sonia Sidhu

October 5th
Hansard Link

Business of Supply

“...m dozens of witnesses—patient advocates and experts in medicine, social policy, constitutional law, pharmaceutical manufacturing, insurance—and the committee asked the PBO to prepare a report, giving ...”

Mr. Richard Cannings (South Okanagan—West Kootenay, NDP)

October 5th
Hansard Link

Business of Supply

“...world, in countries that have universal pharmacare and the strength of negotiating fair prices with pharmaceutical companies, that drug is much cheaper. (1255)

People in New Zealand only pay o...”

Mr. Bill Blair (Parliamentary Secretary to the Minister of Justice and Attorney General of Canada, Lib.)

October 5th
Hansard Link

Business of Supply

“...less effort from the outset of our mandate to reduce the costs and to increase the accessibility of pharmaceuticals for all of our citizens, and of our work with the provinces and territories to try t...”

Mr. John Oliver (Oakville, Lib.)

October 5th
Hansard Link

Business of Supply

“...ow do we make sure, if we launch this final very important step, that all Canadians are covered for pharmaceutical prescriptions?

Why would we not wait? Let the committee address those complexit...”

Mr. John Oliver (Oakville, Lib.)

October 5th
Hansard Link

Business of Supply

“...,000 a year, and that could last for the rest of his life. Who among us can afford this life-saving pharmaceutical intervention without all of us sharing in the cost? All of us and our families face the risk of not being able to access essential medicines because we cannot afford them. We need to work together, pool risk, and support each other, as we have in other important health services.

Our government is already working to improve the affordability of prescription drugs and our access to them. Our current focus is on reducing the price of drugs, which will help improve access to necessary medications. We join provinces and territories as a member of the pan-Canadian Pharmaceutical Alliance, which negotiates lower drug prices on behalf of public drug plans. In the year and a half since joining, we have been able to use this bulk buying power to negotiate 60 agreements that are already saving Canadians money. We continue working collaboratively with the provinces and territories on other ways to make prescription drugs more affordable and accessible for Canadians.

Through the Patented Medicine Prices Review Board, the Government of Canada regulates the maximum allowable prices of patented drugs. The board recently completed the first phase of a consultation with Canadians on changes to its guidelines that would enable it to better protect consumers from excessive patented drug prices.

While much has been done to make pharmaceuticals more affordable for Canadians, I believe more can be done. I do not believe that lowering the cost of drugs would make them any more affordable for that single, temporarily unemployed mother of two. The problem is that prescription drugs outside of hospital care are not covered by the Canada Health Act.

As Canadians, we are proud of our national health care program. Today our national program covers doctor care, most diagnostic services, hospital stays, and prescription drugs while in hospital. It does not cover the $28.5 billion that was spent on pharmacy-filled prescription drugs in 2015.

The Standing Committee on Health, of which I am a member, began a study of the development of a national pharmacare program in 2016. We have heard from dozens of witnesses, including patient advocates. We have heard from experts in medicine, social policy, constitutional law, and pharmaceutical manufacturing, as well as pharmacists and the insurance industry.

In September ...”

Mr. Don Davies (Vancouver Kingsway, NDP)

October 5th
Hansard Link

Business of Supply

“...w whose lives are being shortened in some cases and who are dying because they do not get access to pharmaceuticals because they cannot afford them?”

Mr. Kevin Lamoureux (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.)

October 5th
Hansard Link

Business of Supply

“...iations. There will be very delicate discussions in the years ahead on how to deal with the cost of pharmaceuticals.

When I was first elected back in 1988, I believe our health care expenditures were roughly $1.5 billion. That is my best guesstimate. However, if we look at them today, they are is well over $6 billion. Some may find that a laughing matter across the way, but I can tell members that from a provincial perspective, it consumes over 40% of provinces' budgets.

Before opposition members, particularly New Democrats, start jumping up to say they want a national pharmacare program, they better understand how that program would be financed, unless, of course, they are advocating that the national government pay for 100% of it. However, coming from a party that vowed it would not have a debt, those members do not understand the concept.

There is a responsibility to work with the provinces. I cannot recall offhand from my just under 20 years at the Manitoba legislature, most of them under an NDP administrations, when there was a push to resolve that issue.

Now, within 18 months of coming into government, we have this wonderful initiative by the Minister of Health, the pan-Canadian Pharmaceutical Alliance, which negotiates lower drug prices on behalf of public drug plans. This is ...”

Mr. Kevin Lamoureux

October 5th
Hansard Link

Business of Supply

“... within two years, not to mention what we have already done in regard to trying to keep the cost of pharmaceuticals down, not to mention issues in regard to assisted dying. There are many aspects the ...”

Mr. Don Davies (Vancouver Kingsway, NDP)

October 5th
Hansard Link

Business of Supply

“...l disagree with the two fundamental realities in Canada right now: millions of Canadians cannot get pharmaceutical coverage, and a universal pharmacare system would save billions of dollars.

My hon. colleague pointed out that in terms of working out the details, of course we would have to sit down with the provinces and work out what kind of formulary we would have and how the costs would be shared. The bottom line is that whoever pays for pharmaceuticals now would still be paying for them after universal pharmacare, but they would be pay...”

Ms. Tracey Ramsey (Essex, NDP)

October 5th
Hansard Link

Business of Supply

“...ations.

Currently people are not benefiting from our system, but do we know who is? It is the pharmaceutical and private insurance companies, the same ones that make billions of dollars in profit every year. Did members know that in 2016 Merck Canada made a $35.2 billion profit, while Bristol-Myers Squibb earned $19.2 billion? What about the fact that in 2016 Purdue Pharma reaped profits of $31 billion? Purdue sells oxycontin and other products prescribed for the treatment of pain, and Purdue has been found to have misled doctors about the safety and effectiveness of oxycontin. As we all know too well, Canada is facing a public health crisis in which at least 2,400 Canadians died as a result of opioid overdose in 2016.

What about the top private insurance companies? Do members know that the top three companies in Canada collectively raked in net profits of over $8 billion in 2016?

Pharmaceutical companies can charge higher prices for drugs because they sell to so many buyers. Pri...”

Mr. Bill Blair (Parliamentary Secretary to the Minister of Justice and Attorney General of Canada, Lib.)

October 5th
Hansard Link

Business of Supply

“...d by the federal government through the Canadian Institutes of Health Research, or CIHR, related to pharmaceuticals.

Our government recognizes that the price of drugs affects the life of all Canadians, and ensuring equitable access to necessary medicines is a priority for our government. More precisely, working with the provinces and territories to improve access to necessary prescription medications is one of our top priorities. This will include joining with the provincial and territorial governments to negotiate common drug prices, reducing the costs that Canadian governments pay for these drugs, making them more affordable for Canadians, and exploring the need for a national formulary. That is why, through CIHR, our government is investing approximately $1 billion in research initiatives that will generate new knowledge and evidence and lead to better and more affordable treatments for Canadians.

I would like to discuss some important initiatives supported by these investments that will lead to more affordable treatments and better health outcomes for Canadians.

Clinical trials are the cornerstone of evidence-based practice and ensure timely access to new drugs and treatment for Canadians. For this reason, CIHR recently announced it will be investing $11.7 million annually in an initiative that will focus on the development and implementation of innovative methods in clinical research, the innovative clinical trials initiative. This specific initiative is part of the larger strategy for patient-oriented research by a national coalition of federal, provincial, and territorial partners dedicated to the integration of research into care. The innovative clinical trials initiative will contribute to increasing Canadian competitiveness in innovative clinical trial research and provide a stimulus for research to adopt new methodologies to conduct clinical trials. It will also encourage collaboration with various stakeholders, including patients, decision-makers, and key stakeholders.

Innovative clinical trials use alternative designs to traditional trials methodologies. These new methods can reduce the cost of conducting trials, thereby reducing the amount of time needed to answer research questions, and they increase the relevance of research findings for patients, health care providers, and policy-makers. The direct outcome of these new methods is improved effectiveness of the trials while keeping the same high safety and effectiveness standards for the drugs. This will lower the cost of drug development, ensuring that new, affordable, and effective drugs are available for Canadians.

A priority for the federal government is to improve access to necessary prescription medications. It is important to note that as more people gain access to prescription medication, evidence-based information is required on the safety and effectiveness of the pharmaceuticals. That is why the federal government, through CIHR and Health Canada, created the Drug Safety and Effectiveness Network, to give Canadian decision-makers the evidence they need on post-market drug safety and effectiveness. Launched in 2009, the Drug Safety and Effectiveness Network receives $10 million per year in ongoing funding from the Government of Canada to support its activities, and represents a national network of over 150 researchers. CIHR's investment in the network is making a real-world difference. Since its inception, the Drug Safety and Effectiveness Network has funded over 125 research and capacity-building projects to help those setting policy and delivering health care make informed decisions.

To facilitate this knowledge-translation process, the network developed a collaborative agreement with the Canadian Agency for Drugs and Technologies in Health, also known as CADTH, an independent organization to disseminate its study results to provincial and territorial authorities. This collaboration creates the capacity to respond in a timely manner to the drug safety and effectiveness queries of decision-makers, and ensures that the most effective drugs are accessible to Canadians.

The federal government recognizes the importance of evidence-based policies, which is why, through CIHR, it has supported the research of Dr. Steve Morgan at the University of British Columbia. Dr. Morgan is an expert in pharmaceutical policy and his research focuses on examining the balance between providing equitable access to medicines and responsible health care spending. From 2009 to 2014, the federal government invested almost one and a half million dollars to support Dr. Morgan and other policy researchers who formed a pharmaceutical policy research collaboration. In 2015 this research collaboration released a report ...”

Mr. Bill Blair

October 5th
Hansard Link

Business of Supply

“...ng work that has taken place over the past several years to ensure that we do our very best to make pharmaceuticals available, accessible, and affordable for all Canadians. That work continues unabate...”

Mr. Ramez Ayoub (Thérèse-De Blainville, Lib.)

October 5th
Hansard Link

Business of Supply

“...tional pharmacare program, the necessary groundwork must be laid to support efficient management of pharmaceuticals in this country.

That is why I am pleased to be here today to talk about appropriate prescribing and use of drugs. Appropriate prescribing is an important component of our government's commitment to improving the affordability, accessibility and appropriate use of prescription drugs.

Significant increases in the use of prescription drugs to treat health problems have led to an increase in inappropriate use and unnecessary spending on these drugs.

Inappropriate prescribing for seniors comes with a specific set of concerns. More than 80% of Canadians over the age of 65 take at least one prescription drug regularly. In fact, one in three Canadians takes five or more medications a day. It is estimated that 37% of these prescription drugs are potentially harmful or ineffective, costing the health care system more than $400 million a year.

The World Health Organization estimated that in 2012, half of the world's drugs were either prescribed, dispensed, or sold inappropriately, and that half of all patients failed to take them correctly. A proper prescription aims to improve prescription drug use by ensuring that the right drug is prescribed to the right patient at the right time. Our government acknowledges that it is an important part of our health care system that we have to improve if we want to reduce waste, protect patients from unnecessary harm, and make progress in health care.

Patients seek prescription drugs when they are sick, and prescribers use their expertise to choose drug treatments for their patients. When prescribed and used appropriately, prescription drugs can prevent sickness, improve productivity and quality of life, reduce absenteeism, support mental health management, and even cure illnesses.

In fact, when appropriately prescribed and used, drugs are an essential part of clinical care. However, 50% of Canadians do not take their drugs exactly as prescribed. Furthermore, questionable prescribing practices lead to both inefficiency and waste. If they are not used appropriately, prescription drugs can cause serious harm and put additional pressure on other parts of the health care system.

According to the Canadian Society of Hospital Pharmacists, every year, drug non-compliance is the cause of 10% of all hospital admissions and 25% of hospital admissions for the elderly. Every year, 200 drugs are approved, and it is very difficult for prescribers to keep their knowledge up to date.

Many of the new drugs that are authorized for use in Canada each year come with higher price tags but very few additional clinical benefits compared to other less expensive drugs that are already on the market. The appeal of these new drugs may lure patients and prescribers into using them instead of existing drugs or other treatments that are more effective.

Unfortunately, our health care system does not always give prescribers the support they need in choosing the best drugs for their patients. In Canada, colleges of physicians and medical associations develop clinical guidelines to help with prescribing drugs. However, many of these guidelines are developed with the help of industry funding and are not subject to quality checks.

In budget 2017, we allocated additional funding to the Canadian Agency for Drugs and Technologies in Health, or CADTH, to help support existing intergovernmental efforts to ensure that drugs are prescribed and used properly. That includes identifying best practices and promoting new implementation strategies for appropriate use. (1530)

CADTH is responding to the need for more guidance on prescribing practices by adapting its products and services. In the future, CADTH's appropriate use programs will include evidence-based prescribing guidelines and examine the comparative efficacy of non-pharmacological treatment options. For example, CADTH's review of first- and second-line pharmacological diabetes treatments meets the need for more sound evidence about categories of drugs, not one drug in particular. This will help prescribers select the right drug and optimize its therapeutic use.

In the past, our ability to address inappropriate prescribing was impeded by limited access to reliable national data on prescribing practices and the use of prescription drugs. Without that kind of data, our understanding of the problem and our ability to address it are limited. Without sound, objective evidence, programs to promote appropriate prescribing and repair the damage done by inappropriate use cannot be designed to focus on the areas of greatest need.

We responded to this challenge with federal investments in budget 2016 and budget 2017, so that Canada Health Infoway could work with the provinces and territories to develop a national electronic prescription program to allow health professionals who issue prescriptions and pharmacists to share information electronically.

This system, called PrescribeIT, will help reduce prescription errors, inform pharmacists of potentially dangerous drug interactions, and help patients take their medication as prescribed. Since it will be integrated into existing drug information systems in the provinces and territories, it will provide decision-makers with a more accurate overall picture of pharmaceuticals in Canada.

PrescribeIT is already in use in Ontario, where the first electroni...”

Mrs. Cathy McLeod (Kamloops—Thompson—Cariboo, CPC)

October 5th
Hansard Link

Business of Supply

“... Yellowhead.

I want to thank the NDP for this motion, because the discussion around access to pharmaceuticals is really important. Today we are having an important discussion for all Canadians.

We have heard about the many people who are having challenges accessing medicines. Despite this being an important debate, the NDP has jumped to a one-model solution. I am not entirely convinced that a one-model solution would really be in the best interests of Canadians as we move forward.

The NDP members have lots of heartfelt goals they want to achieve, whether universal child care or housing or many other items. Here I would also note that they tend to be complicit with the Liberals in supporting things that destroy our economy instead of building it. The very difficult news today about energy east and the government's decision to back away from that project was applauded by the NDP. The Liberals made it such a challenge to move that forward.

The NDP are complicit with the Liberals in creating an economic environment that will, over the next few years, make it more challenging to enact the programs they want for Canadians. There should be some careful reflection by both the Liberals and the NDP on how to create an economy that will allow us to do the things that all Canadians want us to do, whether around pharmaceuticals or giving a hand up to those in need. That is my first point.

The next point I want to make is about the issue of constitutional jurisdiction. I remember being on the health committee. At the time, the Bloc had official party status. I can remember that whenever we talked about doing anything national for health, the Bloc members regularly reminded us that health was in their jurisdiction and that federal government should give the provinces the money but not talk about moving forward with any national programs. They felt that the provinces were very capable of dealing with it. The Bloc members said it very explicitly. We hear that from many of the provinces. Even in the most recent negotiations that were held, we heard the provinces saying that the federal government should send the money, but they were very reluctant to be told what to do with it. I think they are rightfully concerned about any large federal government program.

Again, the federal government should probably stick to the pieces of governance that it is actually responsible for. I look at the Liberals and the Phoenix pay system as an example. If the federal government cannot even create a pay system to pay its own employees, how can we expect it to implement a national pharmacare program? The government has a couple hundred thousand employees it needs to pay, but it is much more complex to have a national pharmacare program providing drugs for millions of people. I would be very leery of putting anything like this into the hands of the Liberal government especially, which has shown itself to be inept at that kind of delivery. It is not in the federal government's responsibilities.

I look at the medical marijuana issue, which is another area where the Liberal government, quite frankly, has created a real mess. We have landlords whose homes are being ruined. The Liberals have set up a system that will not work very well, because that is not their area of expertise.

If the NDP is suggesting that they want the Liberal government to take over negotiations and create something that is very complex, it should perhaps rethink what it is asking for.

I really do want to talk about the solutions. (1615)

Ten percent of the population is under-insured, and 2% is not covered by a plan. I think that every one of us agrees that we need to find a way to deal effectively with the examples we have heard today. We need to make sure that someone has their diabetes medication, especially those with low incomes. Just as I have always said that the government should not be paying for my child care when I can afford it, we should be focusing on the people who cannot afford child care and to work at the same time.

I also believe there is a role and an opportunity for those of us who, quite frankly, have advantages in life to pay our fair share and to save those valuable dollars for the people who perhaps need it the most. That is the whole idea of universality versus having people support themselves, and we need to make sure that when the opportunities arise, they can take advantage of them.

I want to talk about British Columbia, which we have not talked much about. Some provinces have moved forward, and again this is about the nimbleness of the provinces and their ability to create a system and solutions that work for their province. What might work in Prince Edward Island, which is a small island, might not work in British Columbia, which is much larger, more diverse, and has many more issues in terms of rural and remote communities. This universal one-size-fits-all approach is probably not going to be the most effective way to deal with it.

A number of years ago, B.C. put in fair pharmacare, a provincial income-based program designed to provide fair access to coverage for prescription drugs. The lower a person's income, the more assistance the government will provide them toward eligible drug costs. It is available to single people or families. For example, if a person's net income for two years is $15,000 or less and they are registered for fair pharmacare, they will have 70% of their eligible prescription drug costs covered immediately, with no deductible.

I think that is a good example where, perhaps, if there were additional money provided for the pharmaceutical system, they might be able to look at it and be more responsive. There might still be...”

Mrs. Cathy McLeod

October 5th
Hansard Link

Business of Supply

“... able to bring their status card, see a pharmacist, and have the seamless provision and delivery of pharmaceuticals.

On the issue pf appropriate prescriptions, we all know about the opioid crisi...”

Ms. Cheryl Hardcastle (Windsor—Tecumseh, NDP)

October 5th
Hansard Link

Business of Supply

“...and $5 billion a year because of employment related private insurance that is ill-quipped to handle pharmaceutical costs effectively? Would the member not agree that this inefficiency creates unnecess...”

Mr. Jim Eglinski (Yellowhead, CPC)

October 5th
Hansard Link

Business of Supply

“... 13.4% of Canada's total health spending, which is $214 billion a year. A singular preoccupation on pharmaceutical cost containment risks missed opportunities for cost savings in other areas of the he...”

Ms. Brigitte Sansoucy (Saint-Hyacinthe—Bagot, NDP)

October 5th
Hansard Link

Business of Supply

“...a universal pharmacare program, the price of both patented and generic drugs is negotiated with the pharmaceutical companies. Buying drugs for entire populations gives these countries a lot of bargaining power. Depending on the plan, they negotiate the bulk price, establish budgets, hold competitive bidding processes for companies, and consider bundling several drugs.

Most drug expenditures come from thousands of private plans wherein people either have absolutely no power to negotiate lower prices or have no interest in doing so because workers and employers are the ones who pay for the drugs, not the insurance companies. The negotiations the provinces hold for their public plans have led to higher prices for the rest of the population, who are covered by private plans or who have no coverage. A universal pharmacare plan would give the government more power to negotiate with pharmaceutical companies.

This would also be the end of a no-win research and development strategy dictated by major pharmaceutical companies. The cost of newly approved medications is set by a federal body, the Patented Medicine Prices Review Board. This board examines the price of medications in other countries and uses the median price to set the Canadian price. However, the countries used for comparison purposes are those with the highest prices in the world, so we end up with unnecessarily high prices. This approach was intentional; it is part of an industrial policy that aims to increase the investments of pharmaceutical companies in research and development and job creation. It is no wonder the Liberals talked about research all day long. This policy, however, has proven to be an abject failure because investments in research and development between 1998 and 2013 declined dramatically compared to sales. It is high time to curb the powers of pharmaceutical groups in Canada.

Currently, New Brunswick, Alberta, and Quebec do offer pharma...”

Mr. Kevin Lamoureux (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.)

October 5th
Hansard Link

Business of Supply

“...he Manitoba legislature, that I have been a strong advocate on the health care file.

However, pharmaceuticals are one of the aspects of health care that quite often do get overlooked. For exampl...”

Ms. Cheryl Hardcastle (Windsor—Tecumseh, NDP)

October 5th
Hansard Link

Business of Supply

“...Does the member see the relationship? Do those needs for health care services come from the cost of pharmaceuticals; maybe people are denying themselves and requiring more health care?”

Ms. Linda Duncan (Edmonton Strathcona, NDP)

October 5th
Hansard Link

Business of Supply

“...d in this place that the Standing Committee on Health has been examining the issue of the access to pharmaceuticals to Canadians, the problem of rising costs and the fact that those who are not well e...”

Mr. Kevin Lamoureux (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.)

October 5th
Hansard Link

Business of Supply

“...mer minister of health was to get the provinces to come together to deal with lowering the costs of pharmaceuticals. The minister of health also achieved the health care accord. All of that within 18 ...”

Mr. Don Davies (Vancouver Kingsway, NDP)

September 28th
Hansard Link

Oral Questions

“... a public health care system that does not include prescription drug coverage, and the high cost of pharmaceuticals is forcing too many Canadians to choose between refilling their fridge and refilling...”

Mr. Bill Blair (Parliamentary Secretary to the Minister of Justice and Attorney General of Canada and to the Minister of Health, Lib.)

September 28th
Hansard Link

Oral Questions

“...prescribing, we are working with all of our provincial partners to bring prices down and to improve pharmaceutical management.

We look forward to reviewing the parliamentary budget officer's ana...”

Mr. Gagan Sikand (Mississauga—Streetsville, Lib.)

September 26th
Hansard Link

Statements by Members

“...ernoons with the local youth at The Dam in Meadowvale. I also conducted a round table with numerous pharmaceutical companies, hosted by Roche.

Another enjoyable part of the summer was visiting n...”

Hon. Thomas Mulcair (Outremont, NDP)

September 26th
Hansard Link

Oral Questions

“...a year since the Lobbying Commissioner began looking into Liberal fundraisers hosted by the head of pharmaceutical giant Apotex. By the way, we just learned that Apotex is suing the Lobbying Commissio...”

Mr. Raj Saini (Kitchener Centre, Lib.)

September 25th
Hansard Link

Statements by Members

“...armacists Day is “From research to health care”, and today we celebrate the work of pharmacists and pharmaceutical scientists who recognize that taking care of patients means both developing and provi...”

Mr. Francis Scarpaleggia (Lac-Saint-Louis, Lib.)

September 22nd
Hansard Link

Private Members' Business

“...ada lacks drinking water guidelines for suspected endocrine-disrupting compounds found in plastics, pharmaceuticals, and personal care products, such as cosmetics and toothpaste. One reason Canada lacks guidelines for many pharmaceuticals and personal care products suspected of being endocrine disrupters is related to Hea...”

Ms. Elizabeth May (Saanich—Gulf Islands, GP)

September 19th
Hansard Link

Government Orders

“... the 41st Parliament, which was under Conservative government leadership, passed Vanessa's Law, the pharmaceutical industry was not required to withdraw a drug when the Minister of Health asked for it. It took Vanessa's Law to say that the Minister of Health could tell the pharmaceutical industry to withdraw a drug.

Now we are passing legislation, and I think it is ...”

Hon. Kevin Sorenson

September 19th
Hansard Link

Government Orders

“...s that we do have certain bodies and councils that protect consumers. The hon. member mentioned the pharmaceutical industry. Obviously, when we reach into that pill bottle and take a pill, we hope that it meets certain standards. I think all governments, and rightly so, make sure that drug identification numbers and processes are there.

There is also food safety. To be quite frank, we remember the melamine in baby formula in China.

We just assume that there are these groups. We have to live in faith that the government is doing its due diligence in keeping Canadians safe, so in the case of pharmaceuticals, food safety, vehicle safety, yes, Canadians can have confidence. We have the highes...”

Mr. Nathan Cullen (Skeena—Bulkley Valley, NDP)

June 15th
Hansard Link

Government Orders

“...probably want to lobby on behalf of their clients, who pay their salaries. Industry, big banks, and pharmaceuticals hire lobbyists. The lobbyists attend the fundraisers, pay the money to the Liberal Party, and then get a little one-on-one time with the Prime Minister.

The Prime Minister explains it away this way:

Any time I meet anyone, you know, they will have questions for me or they will take the opportunity to talk to the prime minister about things that are important to them.

I love it when he uses the third person. It so impresses me when someone uses the third person to talk about himself.

He went on:

And I can say that in various Liberal party events, I listen to people as I will in any given situation, but the decisions I take in government are ones based on what is right for Canadians and not on what an individual in a fundraiser might say.

That is weird, because if we talk to these lobbyists about why they attended a certain event, they tell us they were lobbying the government on behalf of their clients, and that it was effective because they got some very good, close, personal time with the Prime Minister or various ministers, and it felt very effective.

Business is in the business of business, of advocating and encouraging the policies that work for it. This is not a charitable exercise for a lobbyist. My friend said earlier, it is “the grandness of democracy”. I got a little wispy there for a moment. When someone who works for an industry drops $1,500 on the table to lobby the Minister of Natural Resources, he or she is participating in the grandness of democracy. “Here is my $1,500, on behalf of the mining companies that I represent, to spend time with the natural resource minister.” The minister had promised the Winnipeg Free Press that he would never attend a cash-for-access event. Where was the Minister of Natural Resources two weeks later? He was at a cash-for-access event with people from the natural resources industry.

These dots are not hard to connect, yet for Liberals it seems that they are, because they just produced a bill that will enshrine the status quo. It will say that cash for access will continue. It even falls short of their promise that these events could not be held in private homes, because the bill allows for that to continue.

They said they were to be held in public spaces. That was in their speaking notes at the press conference, The Liberals said they would ensure that fundraisers would be held in public spaces that the public can attend. First of all, there is that slight little hitch: the public can attend if they happen to have $1,500. When I see a sign for public skating, I know what that means. A public swim at two o'clock would mean it was probably a couple of bucks or $4.00, and I can take my kids swimming or skating. If it says that there is public skating at four o'clock and it is $1,500 to get in, it does not feel so much like a public space anymore. Rather, it feels very much like a private space, a Boulevard Club or Granite Club sort of public space, which is a Liberal interpretation of what a public space is.

The bill also has a convenient loophole that has been deemed the Laurier Club loophole. if someone makes the $1,550 maximum donation at a Liberal convention, this law does not apply. Is that not convenient? Where do many people who attain status at the Laurier Club make their donation? It is at a Liberal convention. In fact, according to Liberal records, a quarter of the Liberal donations came from just 4% of their donors. Twenty-five per cent came from 4%. That is according to Liberal records.

If the Liberals scowl and tut-tut, then it must mean the Liberal Party of Canada is lying, which I would never suggest. That has never happened, even with all that sponsorship scandal. In any case, the Liberal Party has reported that this is where its money comes from. (1120)

The list of what the bill does not do is so much longer than what the bill does. It says we are going to report who attends cash for access quicker. We are going to notify the public a few days in advance that the event is happening, and the public is welcome to attend if they have $1,500. There is a special rate for youth, those under 25, because a lot of people I know under 25 have $250 burning a hole in their pockets. I speak with many people in high schools and universities, and I chat with the pages. I am always amazed how they are constantly leaving hundreds of dollars lying around at the coffee shop, the bar, of wherever we are having our chat. It is a funny thing.

Someone just triggered a name, which reminded me that I made an unfortunate comment about a former colleague during question period. Joe Volpe, a former Liberal, served many years in the House. I got a note from his family suggesting that was an unkind comment that caused them some pain. It is only fair for me, certainly because my former colleague is no longer here to defend himself in the way that we do, to apologize for making that comment about Mr. Volpe, and by extension, to his family.

There are two versions of how the Liberals operate. There are the ones who make the promises in the campaign. Sometimes they repeat the promises, even when they form government. Then there is the version of what the Liberals do when they are in government. We need to bring this into some sort of psychological disorder, because Liberals are able to countenance these two alternative realities at the same time.

In November 2015, the Prime Minister said:

There should be no preferential access to government, or appearance of preferential access, accorded to individuals or organizations because they have made financial contributions to politicians and political parties.

That was a promise. He said one does not get access to the Liberal government simply by making a donation, even the appearance of access. That is a very high bar. I thought that was great and I wondered if they could attain it. Then we found out the justice minister, in April 2016, attended a Liberal fundraiser at a Bay Street law firm, Torys LLP, which is registered to lobby the justice minister. There is no problem there, right? We have the justice minister attending a fundraiser by a registered lobbyist with lawyers.

Then the finance minister held a private Liberal Party fundraiser for business executives at the waterfront mansion of a Halifax mining tycoon, and he was pleased to suggest that it was really just a way of holding pre-budget consultations. I have attended pre-budget consultations as part of the finance committee. In my own riding, we held a town hall and welcomed people to come talk to us about what they thought should be in the budget. What did we charge? It was nothing. In fact, I bought the coffee, because I thought that was appropriate. If we want to invite the public to inform how the government should construct the federal budget, which is their money anyway, we should not charge them for the privilege of the conversation.

The finance minister thought that was appropriate. Here is what he said:

I am pleased to say that we have taken on a consultation process for our budget that allows us to listen to all Canadians. ...We have the most open process ever put in place, and we will continue to listen to Canadians as we craft the next budget on their behalf.

He just walked out of a millionaire's mansion, where people paid $1,500 to have that bit of time with him to inform him. That is the “their” he is talking about.

For the middle class, and those struggling to join it, unless people have the $1,500, they do not get to talk to the finance minister the same way.

On October 21, 2016, the finance minister assured us that these events are “open to the public”. Like every member of Parliament, I am actively involved in fundraising activities for my party. Invitations are sent out to hundreds of people, and they are in fact open. Trying to say that access to the finance minister, who is writing the federal budget, is the same as access to any other member of Parliament, muddies the water.

We looked at the email the Liberals sent out inviting people to this event. I do not know a lot about the Internet, but I did learn that when one uses robots.txt that makes the invitation non-searchable. (1125)

Why would they send out an invitation that was not searchable? Do they not want people to know about their event? Usually, I do. I would never use a sneaky backdoor way to make sure that nobody could actually find it. Now we find that the government House leader—this is interesting—had a fundraising event held by a pharmaceutical billionaire who has a lawsuit challenging the federal government's ban on importing two of his company's drugs into Canada. He held a fundraiser for the Liberal House leader. She argued that this event is an example of “lawful and ethical fundraising”. That is her quote.

A billionaire pharmaceutical-company owner who is fighting the federal government trying to get his drugs into Can...”

Mr. Nathan Cullen

June 15th
Hansard Link

Government Orders

“...e that sacred promise to Canadians immediately. We listen to the justifications that get used, that pharmaceutical lobbyists and CEOs get special access, while they have pending business with the government. They are in conflict with the government. They have a financial interest in convincing the government of something that will make them potentially millions of dollars .

It is the rationalization and the justification we hear from Liberals after the fact that speaks to my friend's point. We have this promise, and it should be just bolted into the wall over top of every minister's door, “no special access”. That is job description number one. However, the rationalization afterwards is the Liberals just see no problem with it. There is this ethical blindness. They might meet pharmaceutical lobbyists who are trying to get their drugs into the company. They might meet with a ...”

Mr. Pat Kelly (Calgary Rocky Ridge, CPC)

June 15th
Hansard Link

Government Orders

“...held fundraisers with Chinese billionaires. We know they have held cash-for-access fundraisers with pharmaceutical lobbyists and firms that are in litigation with the government. We have media reports...”


The Senate

Hon. Anne C. Cools

November 30th
Hansard Link

Cannabis Bill Bill to Amend—Second Reading—Debate Adjourned

“... you given any thought to the use of medicine in this way? Historically and traditionally — and the pharmaceutical companies are there to prove this — most medicines are delivered as pills, capsules, ...”

Hon. Art Eggleton

November 8th
Hansard Link

The Honourable Kelvin Kenneth Ogilvie, C.M. Tributes

“... the major policy studies we undertook in that time, such as the health accord review, prescription pharmaceuticals, obesity, dementia and the recently completed report on integrating robotics, artifi...”

Hon. Joseph A. Day (Leader of the Senate Liberals)

November 2nd
Hansard Link

Tributes The Honourable Kelvin Kenneth Ogilvie, C.M.

“...e reports on a variety of topics impacting the health of Canadians: dementia, obesity, prescription pharmaceuticals, robotics and artificial intelligence. In the 2012 report, Time for Transformative C...”

Hon. Judith Seidman

November 2nd
Hansard Link

Tributes The Honourable Kelvin Kenneth Ogilvie, C.M.

“...d. If I might, I will single out the pharma study — a three-year study of the state of prescription pharmaceuticals in Canada — as an example of the groundbreaking work you led. As for myself, senator...”

Hon. Diane Bellemare (Legislative Deputy to the Government Representative in the Senate)

September 27th
Hansard Link

City of Montreal Three Hundred and Seventy-fifth Anniversary

“...ive economy that is known for its vitality in such industries as aerospace, information technology, pharmaceuticals, film, arts and culture, to name a few. (1420) This year, Montrealers have a lot to ...”

Hon. Joseph A. Day (Leader of the Senate Liberals)

September 20th
Hansard Link

The Late Honourable Allan J. MacEachen, P.C., O.C. Tributes

“...in the public interest, such as those dealing with unemployment insurance, prisons, immigration and pharmaceutical drugs. During his time here, there was the epic fight with the government over the Ca...”

Hon. Peter Harder (Government Representative in the Senate)

September 20th
Hansard Link

Delayed Answers to Oral Questions

“...tion; and the question asked by the Honourable Senator Cordy on June 21, 2017, concerning physician-pharmaceutical company relationships.”

Senator Downe

September 19th
Hansard Link

International Trade Canada-European Union Comprehensive Economic and Trade Agreement

“...that were left hanging: the shipbuilding concerns, which are something we would like to pursue, and pharmaceuticals. At the end of June, I had an opportunity to speak to the European trade negotiator ...”

Hon. Jane Cordy

June 21st
Hansard Link

Health Physician-Pharmaceutical Company Relationships

“...dia yesterday that an audit has shown that doctors in Canada are receiving millions of dollars from pharmaceutical companies. In the United States there's a sunshine law, so it's revealed openly what doctors are being given by big pharma.

It's my belief that patients should be aware of whether or not their doctor has received a golf trip or is being paid by a pharmaceutical company or is being taken out to dinners at very expensive restaurants so that they c...”


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