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View Darren Fisher Profile
Lib. (NS)
Mr. Speaker, I am certainly pleased to stand today to address the motion from the hon. member for Vancouver Kingsway. I congratulate him on his speech and I thank him for his work on the health committee.
The government is committed to implementing a national universal pharmacare program that ensures that all Canadians have access to the prescription drugs that they need. This is our goal, as clearly stated in the 43rd Speech from the Throne. It is a goal that we have been working towards for some time. While we are now closer than ever, it is important that we continue our measured, considered approach to implementation. We need to get this right.
This morning I will explain the steps the government is taking to make prescription drugs more accessible and affordable for Canadians. I will also explain why these actions are key to the implementation of a national pharmacare program.
Canadians should not have to choose between buying groceries and paying for medication, but for many people, paying for prescription drugs is a heavy burden and for others it is completely out of reach. Surveys show that more than seven million Canadians are either entirely uninsured or under-insured.
This means that many of these Canadians cannot afford to fill their prescriptions. They simply do without the medication they need. If their health absolutely depends on taking these drugs, they may forgo necessities, such as food and heat, so that they can pay for their prescriptions. We can no longer afford to do nothing. We cannot afford to wait.
That is why we asked Dr. Eric Hoskins and a panel of eminent Canadians to provide the government with a blueprint for a national pharmacare program. After hearing from many thousands of Canadians, the council found a consensus of opinion that everyone in Canada should have access to prescription drugs based on their need and not on their ability to pay.
The government shares this view. With national pharmacare on the horizon, addressing the affordability of drugs is imperative.
How do we do that? The first step is to update specific parts of our regulatory regime and bring them into line with the rest of the world.
Let me begin with a few words about the evolving use of pharmaceuticals in Canada and the associated increasing costs, costs that impact everyone.
Pharmaceuticals are important to the health of Canadians and a vital part of Canada's health care system. Drugs help cure or manage previously debilitating or fatal diseases, allowing Canadians to live longer and healthier lives. Diseases that were deadly 100 years ago, such as tetanus, diphtheria, polio and many others, can now be prevented by vaccination. An HIV diagnosis was a death sentence at one time. New drugs offer innovative treatments for diseases like arthritis, hepatitis C and many types of cancer.
All this innovation comes at a cost. It is part of the reason that Canadians are paying higher prices for prescription drugs than they should. Patented drug prices in Canada are the third-highest in the world, behind only the United States and Switzerland. Canadian prices are, on average, almost 25% more than the OECD median for the same patented drugs. As a result, the private and public drug plans that cover the majority of Canadians are rapidly becoming unsustainable.
Let me give an example. Diabetes affects an estimated 3.4 million Canadians and is one of the leading causes of death in Canada. Canada spends nearly $600 million annually on new oral anti-diabetic drugs. The two top-selling oral anti-diabetic drugs cost Canadian public drug plans close to $1,000 per year per patient, twice as much as in France. Imagine the savings if Canada paid France's prices for these drugs. That is a lot of money. It is money that could be used to cover the cost of drugs for people with limited or no insurance coverage.
A second example is a drug used to treat a rare soft-bone disease. This disease used to be almost always fatal, but this drug changed the prognosis. However, it is one of the most expensive drugs in Canada, costing more than $1 million per year per patient, depending on the required dosage. Unfortunately, this high price resulted in difficult decisions and delayed access to the drug for many Canadians.
If Canada paid lower prices for all drugs, there would be more money available in drug plans to provide better coverage or to provide coverage to those without insurance.
Even outside the area of rare diseases, pharmaceutical costs keep going up. Drugs are now the second-largest category of spending in health care, and biologics and other specialty drugs account for an increasing share of these total drug costs. This rate of growth in drug costs is unsustainable, and it is hurting Canadians every single day.
As a trend toward higher-cost specialty drugs continues, we cannot continue to pay higher-than-average prices for drugs. What could we do? The answer is not to spend more. We already spend more per capita on pharmaceuticals than nearly every country in the world. We need a solution to bring fair prices and sustainable drug costs for Canada.
Part of the problem was that Canada's approach to patented drug price regulations was outdated. Our previous pricing regulations were established in the 1980s. We have more than 100 different public drug plans and thousands of private drug plans, which means that drug coverage is provided by a patchwork of payers.
It was well past time to bring these regulations into the 21st century. Canada needed a modernized approach to regulating patented drug prices, one that would provide long-term sustainability and protect Canadians from excessive prices. That is why last summer the government modernized the patented medicines regulations to provide the Patented Medicine Prices Review Board, or PMPRB, with the tools and information it needs to protect Canadians from excessive prices for patented medicines.
I want everyone to remember that Canada pays the third-highest costs in the world. As a comparison, we pay double what France pays on some drugs.
We will now benchmark prices against countries that are similar to Canada economically and similar from a consumer protection standpoint. Previously, the price ceilings for patented drugs in Canada were set by comparing our prices against prices in seven predetermined countries: France, Germany, Italy, Switzerland, Sweden, the United Kingdom and the United States. The list of countries has now been updated by removing the United States and Switzerland and adding Australia, Belgium, Japan, the Netherlands, Norway and Spain, for a total of 11 countries as comparables.
We then wanted the PMPRB to see the actual prices being paid in Canada, not just the list prices being published by pharmaceutical companies. When the PMPRB was created, the market prices of drugs matched the list prices. Over time, as a result of the significant confidential discounts and rebates negotiated by third party payers, actual prices paid in the market became significantly lower than list prices. Without access to this information, the PMPRB was left to regulate domestic price ceilings based on inflated list prices.
With the modernized regulations, patentees will be required to report Canadian price information as the net of all adjustments, such as rebates and discounts, so that the PMPRB is informed of the actual market prices being paid in Canada.
Finally, we wanted to consider the value that a drug offers and its overall affordability. Most other countries with national pharmacare programs already do this. When setting a price, we need to consider three things. First is the value for money: Does the drug offer a therapeutic benefit that justifies its cost? Next is the size of the market: How many people will benefit from the drug? Last is to consider Canada's GDP and GDP per capita: Can we afford to pay for the drug?
These changes will provide the PMPRB with the tools it needs to protect Canadians from excessive drug prices and bring us in line with the policies and practices of most other developed countries. This was a critical step toward improving the affordability and accessibility of prescription drugs. Taken together, we anticipate that these regulatory changes will save roughly $13 billion over the next 10 years. That is a significant saving for Canadians.
From those savings, public and private drug plans will have greater capacity to improve benefits for plan members or to consider new therapies not currently covered. All Canadians, including those with drug plans and those paying out of pocket, will benefit from lower prices for prescription drugs.
Modernizing pricing regulations complements the work already under way at Health Canada to streamline the regulatory review process for drugs by enabling priority drugs to reach the market more quickly. It supports the work already taking place under the pan-Canadian pharmaceutical alliance to negotiate lower prices for prescription drugs. As a member of this alliance, the Government of Canada is able to combine its buying power with that of the public plans in the provinces and territories.
It is estimated that the alliance saves public drug plans more than $2 billion a year. Successful negotiations result in more affordable prescription drug prices for public plans and lower generic drug prices for all players.
Before we can implement a national pharmacare program in Canada, we have to address the rising cost of drugs in the country by taking the steps I have outlined. Doing so will improve the viability of a national pharmacare program. National pharmacare, in and of itself, would be another step that could help us control drug prices.
I am confident that this government is on the right path. We are now exploring options as we move forward with a national pharmacare plan, and we are making significant investments.
Budget 2019 earmarked $1 billion over two years beginning in 2022, with up to $500 million ongoing to help Canadians with rare diseases access the drugs they need. This is very important. This is an investment that must be made.
Budget 2019 also proposed $35 million over four years to support the creation of the Canadian drug agency, an important step toward a national pharmacare program. We have pledged to work with provinces, territories and stakeholders on the creation of the Canada drug agency. This agency could use its negotiating power to achieve better prescription drug prices on behalf of Canadians. Negotiating better prices could help lower the cost of prescription drugs for Canadians by up to $3 billion over the long term.
I appreciate the opportunity to discuss some of the important work we are doing to prepare for the implementation of a national pharmacare program. Part of this effort involves addressing the affordability of prescription drugs, an essential building block for pharmacare. To do that, we have brought our regulatory approach to pharmaceutical pricing in line with approaches that are used in the rest of the world. The actions we have taken to improve the system will help to bring down the prices of prescription drugs.
I would very much like to thank the hon. member for Vancouver Kingsway for his motion. I am pleased to say that we are moving forward steadily. Each of the actions I have described today is helping to pave the way for an effective pharmacare program.
From bringing down prescription prices to improving the management of these drugs in our health care system, we are taking the time necessary to get this right, keeping in mind that the provinces and territories will have a key role to play in determining how pharmacare will take shape.
Pharmaceuticals are an important part of Canada's health care system. That is why federal, provincial and territorial ministers of health have made affordability, accessibility and appropriate use of prescription drugs a shared responsibility.
The updates we have made to the patented medicines regulations, when taken together with the Patent Act, will provide the PMPRB with the tools to protect Canadians consumers from excessive patented drug prices.
All of these measures are important steps in our plan to prepare for the implementation of a national pharmacare program. It is critical that the government work closely with the provinces and territories, as they play a key role in the development of a drug agency, the strategy for high-cost drugs and for rare diseases. Together we are making progress toward a more efficient and effective system.
Based on these initiatives and others I have outlined today, it is clear that we are in fact moving forward with the recommendations from the Hoskins report. I am pleased to support today's motion and urge other hon. members in the House to do so as well.
We must continue to collaborate with the provinces and territories. Our government looks forward to continuing these discussions while taking the critical next step to implement national universal pharmacare.
View Darren Fisher Profile
Lib. (NS)
Mr. Speaker, a lot of work has already happened in the last couple of years. A lot of collaboration has already begun and there are a lot of positive steps.
As we move forward on implementing national pharmacare, we have to continue to collaborate with the provinces and territories. I believe there is a meeting very soon, this spring in fact. Our government looks forward to continuing these discussions while taking critical next steps to implement national pharmacare.
View Darren Fisher Profile
Lib. (NS)
Mr. Speaker, this is a very serious issue. We need to do some serious work on a rare diseases strategy for Canadians. It is very important. As it pertains specifically to Trikafta, the company has not submitted an application to market this product in Canada.
However, working toward the rare diseases strategy, budget 2019 put forward a billion dollars over two years and $500 million each year ongoing to come up with a way to solve this issue so Canadians have access and affordability.
I spoke about the fact that we paid the third-highest prices. Why is Canada paying the third-highest prices for pharmaceuticals in the world? Why is it twice as much as some countries? Why are we paying 25% more than OECD countries on average? We need to find a balance between affordability and accessibility so all Canadians can be safe and healthy.
View Darren Fisher Profile
Lib. (NS)
Mr. Speaker, I thank my colleague for her question.
I want to congratulate Quebec on doing a great job with moving toward national pharmacare. Quebec has one of the models for our country.
As the member said, Canadians do pay the highest prices in the world for prescription drugs, the third-highest behind the United States. We already have done more than any government in a generation to lower drug prices. We have new rules on patented drugs that will save Canadians over $13 billion. We joined the pan-Canadian pharmaceutical alliance. Now we are taking the next critical steps to implement national pharmacare. We will not rest until Canadians can get and afford the medications they need.
View Darren Fisher Profile
Lib. (NS)
Mr. Speaker, I would not want to presuppose an outcome or what may or may not come to be when so much of the responsibility, so much of partnership with the federal government will be the provinces and territories. It is so important to not try to foist upon provinces and territories what the federal government wants, but to work closely with the provinces and territories to determine what is best for them and for Canadians to ensure access and affordability for all Canadians.
View Darren Fisher Profile
Lib. (NS)
Mr. Speaker, this is a very sensitive and serious issue in Canada. We spoke earlier about Trikafta and how there had been no application for its approval in Canada yet. I know there are other issues.
For serious or life-threatening conditions, such as cystic fibrosis, there is the special access program. It does work and it has worked. However, we would not necessarily put specifics on what the $1 billion looks like until we form a partnership with the provinces and territories in order to move forward.
The $1 billion over two years and the $500 million ongoing each year is to ensure we can solve these problems the member has spoken about in the House before, which, frankly, are very serious and affect me personally.
I appreciate the comments of the member and the questions he has asked. We know we have to work on a rare diseases strategy. We have put the money in budget 2019 and in future budgets. We will continue to do the absolute most we can for Canadians.
View Sean Fraser Profile
Lib. (NS)
View Sean Fraser Profile
2020-03-12 13:04 [p.2002]
Madam Speaker, I will be sharing my time with the member for Bonavista—Burin—Trinity.
Today's motion is about pharmacare. Perhaps I will lead with my conclusion. I will be supporting this motion. I will be supporting it because quite frankly I am sick of knocking on the doors of seniors who tell me they have to split their medication because they cannot afford it, not only putting themselves in a difficult financial position but reducing the effectiveness of the medicine they have been prescribed.
Most of the people I talk to at home, and I dare say most Canadians, are happy with their own coverage right now. However, the golden thread that runs through the social fabric of Canada is that as Canadians, we care as much about our neighbours as we do about ourselves. It is incredibly frustrating for me to know that one in five Canadian households report that a family member is not taking his or her medication because he or she cannot afford it. I am sure that the 36 million Canadians who do not suffer from this problem are disappointed to know that one million Canadians cut back on their food or home heating because they cannot afford the cost of their pills. When my neighbours cannot afford the cost of their medication, it decreases the quality of my life to know I live in a society that does not adequately take care of its vulnerable.
One of the greatest frustrations I have as a federal member of Parliament is that the number one issue for my constituents is their health care system, whether that is access to a family doctor, the quality of mental health services, in-home care for their aging parents or a lack of access to quality medications. They sometimes end up at my office, despite the fact that health care is primarily a provincial responsibility under our Constitution. It is cold comfort for the people who bring these kinds of concerns to my office for me to say that I have to wash my hands of it because it is a provincial responsibility. What they are looking for is help in often desperate circumstances.
Despite the fact that there is this constitutional division of power, there are concrete things the federal government can do, such as transfer more money to the provincial health care systems, invest in research, invest to ensure we can do something to combat the family doctor shortage, or, yes, implement a national pharmacare program to ensure people have access to the medications they have been prescribed so they can be healthy, regardless of the financial circumstances they may have been born into through no fault of their own.
There are two categories of problems I see with the lack of access to an adequate national pharmacare system.
First is the lack of access to medication because of issues surrounding affordability. I find this to be a real problem. It discriminates against our seniors on the basis of their age, because they do have increased health care concerns as they get older. It discriminates against people who are living in poverty, because they cannot afford to access drugs.
It is heartbreaking to knock on a door that is answered by a child who has not had enough to eat that day and then to sit down with his or her parents, who explain the child has been prescribed medication to which they do not have access. It also discriminates against people who have an underlying health condition that may not be the subject of coverage through private or public insurance plans. In fact, of the people who report they cannot afford their medication, 38% have access to a private insurance plan and 21% have access to public coverage that does not cover their needs.
Second, in addition to the lack of access is an issue around the lack of systemic savings that we are not benefiting from because we have not been moving forward.
The Parliamentary Secretary to the Minister of Health, a colleague of mine from Nova Scotia, quite eloquently has described the fact that Canada is the third most expensive country in the world when it comes to the costs of medication, ranking only behind the United States and Switzerland.
We are so proud of our public health care system and the universality of it. No matter where people come from or who their parents are, they will be taken care of when they fall ill. The same is not true, and a lot of Canadians do not appreciate this, when it comes to access to the medications they need, which are often to sustain life or remain healthy.
Part of the reason this is the case in Canada is that we have a very serious patchwork of provincial and territorial programs and over 100,000 private sector health care plans in Canada. We do not necessarily benefit from the opportunity that presents itself when we can negotiate bulk purchases of medications. Some efforts have yielded success by partnering with various provinces. However, if we adopt the Costco model and buy in greater volume, we can reduce the price per unit and extend access to people who currently cannot afford their medication.
I have seen estimates in excess of $4 billion of systemic savings that come not only from a reduced cost in the price of medication, but also fewer visits to emergency rooms, fewer hospitalizations and more seniors being taken care of in their homes because they can afford access to the medication they need to be well.
We all can appreciate that there is a problem with access to medication in Canada. Over the past few years we have been working toward solving this problem.
Just a few years ago, we appointed an advisory committee, led by Dr. Eric Hoskins, the former minister of health for the Province of Ontario. That effort led to a report that identified the path forward to a national pharmacare program. The committee flagged that it would not happen overnight, but there were certain things that needed to happen to bring down the cost of drugs so we could benefit from the systemic savings that would accrue once we implemented those steps.
One of the very first steps we thankfully moved forward with in the last federal budget, with a $35-million investment, was the creation of the Canada drug agency. This body would be able to assess the effectiveness of drugs that could be proposed to enter into the Canadian system. It would provide an opportunity to negotiate better prices because of the purchase of increased volume that could be administered through the provincial public health care systems. The creation of a national formulary would allow us to ensure we would have consistent coverage, regardless of which community of province in Canada one may live.
In addition to the creation of the Canada drug agency, we have created a national strategy for high-cost drugs and rare diseases. This is important. Quite a few Canadians live with a condition that, despite the fact they may have coverage, do not have access to the medication because of its exorbitant cost or their insurance policy may not provide coverage for their particular condition or its required medication. We have earmarked $500 million annually for this approach.
It is simply not fair that the circumstances of people's birth means they would not be entitled to benefit from the medication that could keep them alive. There are still problems in Canada. Tragic cases pop up in every corner of our country each week. However, by moving forward with this rare disease strategy, we will be able to help some of the most vulnerable Canadians.
In addition to the creation of a drug agency and rare disease strategy, we have also moved forward with changes to patented medicine regulations, changes that will save billions of dollars to our health care system. One of these changes adds additional factors that need to be considered so the cost of drugs reflect the benefits to public health care system in which they can enter. Some of the regulations will require better reporting to ensure our regulations reflect the actual cost of medication.
Perhaps most important, from my perspective, is we have changed the comparator basket of countries we look at to set drug prices for Canada by removing the United States and Switzerland, the two most expensive countries in the world, and added other comparator countries with similar economies, such as the Netherlands and Japan, which will lead to a systemic reduction in the cost of medication in our country and, most important, for Canadians who need that help.
Health care is front of mind for people back home, whether it is access to a family doctor, the fact that their parents cannot find a place in a long-term care facility or the underserved mental health services in their communities. I hear about these things non-stop because people recognize there are problems. Whether they live with those problems or not, they are equally concerned for the people who live in their communities who do not have access to life-saving services and, importantly, life-saving medication.
There is something we can do. We can implement a national pharmacare program to ensure that no matter where people live, no matter where they were born or their parents' economic situation, they will not be denied access to medication because of their financial circumstances.
It is Canada in the 21st century. Canadians expect that they and their neighbours will have access to the medications they need to be well. By implementing a national pharmacare program, we can turn that dream into a reality for the millions of Canadians who go without the medicines they so desperately need.
View Sean Fraser Profile
Lib. (NS)
View Sean Fraser Profile
2020-03-12 13:14 [p.2004]
Madam Speaker, there is a lot to unpack in that question, but I will do my best to address it.
In addition to my frustrations with the shortcomings of the provincial health care system, there are other issues squarely within the federal purview that I care deeply about, notably the fight against climate change and solving income inequality in Canada, which in turn will actually have benefits for our provincial health care systems.
That being said, there are items within the federal purview that allow us to demonstrate leadership and assist the provinces in delivering the quality of care our citizens so desperately need.
In terms of the question regarding the increases to the quality of the financial transfers, I will note that we actually did land on a 10-year health accord that has seen the federal transfer go up. On top of that, we have created additional investments. My province of Nova Scotia has $288 million additional dollars for in-home care for seniors and to improve mental health services.
I would be happy to go over the role I see for the federal government to improve health care services with the hon. member at his leisure.
View Sean Fraser Profile
Lib. (NS)
View Sean Fraser Profile
2020-03-12 13:16 [p.2004]
Madam Speaker, to reiterate my opening comment, when I said I would lead with my conclusion, I will be supporting this motion. I speak not for the government, but for myself. I hope my colleagues will do the same.
The fact is that we have a time-limited opportunity in this minority Parliament to make a real difference that will extend access to medication to some of Canada's most vulnerable. I will never forgive myself if I do not take the opportunity to do everything within my power to ensure the most vulnerable Canadians have access to the medication they so desperately need.
View Sean Fraser Profile
Lib. (NS)
View Sean Fraser Profile
2020-03-12 13:18 [p.2004]
Madam Speaker, very quickly, we started by launching a nationwide consultation through the advisory council led by Dr. Hoskins. We followed that up with the creation of the Canada drug agency, which will ensure we can benefit from both purchasing and guarantee the effectiveness of drugs that enter the system.
Since then, we have made changes to certain medications to ensure we can bring the cost down and have some consistency in coverage. We have advanced a rare disease strategy, backed by hundreds of millions of dollars, to ensure the most vulnerable have access. These are the first steps in the process. We will get there and achieve universal coverage for drugs for Canadians.
View Jaime Battiste Profile
Lib. (NS)
View Jaime Battiste Profile
2020-03-12 14:01 [p.2011]
Madam Speaker, I rise today to commend and congratulate a Cape Breton teacher and musician. Mr. Carter Chiasson, a teacher at Allison Bernard Memorial High School in Eskasoni, was awarded the 2020 MusiCounts Teacher of the Year Award. This award recognizes inspirational and passionate Canadian music educators' impact on students.
We all remember that teacher who went above and beyond the call, who did more than instruct but inspired. Carter's dedication and talent has helped students reach their amazing musical potential over many years. Recently, Carter's rendition of The Beatles' Blackbird sung in the Mi'kmaq language by Emma Stevens has been viewed more than a million times on YouTube and was nominated for a Nova Scotia music award for best music video. When Sir Paul McCartney himself praises someone's video publicly, the person knows he or she has reached greatness.
I congratulate Carter on this well-deserved honour.
View Kody Blois Profile
Lib. (NS)
View Kody Blois Profile
2020-03-12 14:17 [p.2014]
Mr. Speaker, I have said it before in the House and it bears repeating: Acadia University is a key institution in my riding of Kings—Hants, and of course the entire Annapolis Valley.
Acadia is not only an excellent institution for higher learning and education, creating important relationships around the globe for Nova Scotia, the university also has a rich sporting tradition. Acadia's sporting tradition will add another chapter this weekend as Acadia plays host to the University Cup, a hockey tournament that brings together the top varsity programs from across the country, which is fitting given that Windsor, in Kings—Hants, is the birthplace of hockey.
This weekend, eight teams will vie for the title of national champion at the Scotiabank Centre in Halifax. Acadia begins the tournament with a quarter-final matchup tomorrow evening against the University of Ottawa. As I stand proudly in the House wearing the Acadia Axemen jersey, I would like to wish all teams and players an enjoyable experience in Nova Scotia. Particularly, to the members of the host team, I say we are in their corner and go, Acadia, go.
View Geoff Regan Profile
Lib. (NS)
View Geoff Regan Profile
2020-03-12 14:48 [p.2020]
Mr. Speaker, since 2008, an organization in Halifax, Hope Blooms, has been making a difference. It has had a measurable impact on food security and social inclusion. It actively engages youth to grow food in its 4,000 square feet of organic garden. Through hard work, its members are improving social inclusion and food security. They even appeared on Dragon's Den, where they secured $40,000 to build a new greenhouse.
The Minister of Agriculture and Agri-Food was in Halifax last week to meet with them. Could she inform the House on how the government is supporting this kind of project?
View Sean Fraser Profile
Lib. (NS)
View Sean Fraser Profile
2020-03-12 14:52 [p.2020]
Mr. Speaker, the government will always stand for Canadian workers and Canadian interests.
In response to the unjustified U.S. tariffs on steel and aluminum, we provided targeted relief to begin countermeasures for Canadian manufacturers. As we have always said, all money collected through the retaliatory tariffs will go back to support the industry.
With the unjustified tariffs removed, we are going to continue to work with the industry, and expect that additional compensation could be provided over the next two years. More than $1.3 billion to date of support has been delivered to defend and protect the interests of Canadian workers, and additional support remains available for those who need it.
View Sean Fraser Profile
Lib. (NS)
View Sean Fraser Profile
2020-03-12 14:54 [p.2021]
Mr. Speaker, I note that the question is nearly identical to the one I just provided an answer for, so I apologize in advance if I sound like a broken record.
We have provided $1.3 billion to date in support for the steel and aluminum sectors in response to these retaliatory tariffs. In response to the unjustified tariffs, the case remains that every dollar collected will go back to support the industry. With the unjustified tariffs now being removed, we are going to continue to work with the industry, and expect that additional compensation will flow over the next two years.
We are going to ensure that we are there for the industry as the need may arise.
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