Canadian Health minister accused of meddling in work of drug price review board
A former board member tells MPs Jean-Yves Duclos has set
a dangerous precedent
Health Minister Jean-Yves Duclos' request to suspend consultations on guidelines that would lower the price of pharmaceutical drugs has made it harder for the Patented Medicine Prices Review Board to do its work, a former board member told MPs Tuesday.
Matthew Herder — who resigned from the board in February, citing a lack of government support for needed reforms — told a parliamentary committee that Duclos' interference in the board's work has set a dangerous precedent.
"Industry now knows that it can bypass the [Patented Medicine Prices Review Board] when it isn't satisfied with the board's policy direction and get the minister to do its bidding," Herder said.
In 2016, the federal government announced that it would protect Canadians from excessive drug prices by launching consultations on proposed amendments to regulations. The Patented Medicine Prices Review Board (PMPRB) was tasked with consulting industry and other stakeholders and coming up with guidelines.
In November, Duclos sent a letter to the acting chair of the PMPRB asking the board to suspend consultations on the policy reforms just weeks before new drug price guidelines were supposed to come into play.
Herder and former PMPRB executive director Douglas Clark told MPs Tuesday that Duclos interfered with the independence of the board by halting consultations on new guidelines.
Duclos denied the allegations during his testimony last Thursday. He said that he asked the PMPRB to suspend consultations because he had not been included in conversations about the new drug price guidelines and that more consultations were needed with the provinces.
"I had never received an invitation by the board, through its chair, to meet members of the board," he said.
Request vs. demand
Clark told MPs that the board had seven briefings at the official level. He also said that he made multiple attempts to reach the minister but was ignored.
"I made … five attempts to reach out to the minister's office to obtain a briefing with the minister," he said.
While Duclos said that the letter was only a suggestion, Herder said it felt more like a demand.
"The letter was a request as it was worded but it happened … in a context where there were multiple attempts to reach his office and the answer back was silence ... that's why it came across more of demand than a request," he said Tuesday.
Clark told the committee the government expected that everyone "was going to have a good time and get along." He said that was not possible when PMPRB was working on guidelines that would decrease industry profits.
"PMPRB is the David to the Goliath of transnational trillion-dollar industries." Clark said. "If the expectation is that we are required to operationalize a policy that will remove $10 billion or $3 billion out of industry profits in a way that has the blessing of that industry, it's a recipe for futility,"
Canadians are paying high costs for drugs
Canada has the third highest pharmaceutical drug prices in the world, after the United States and Switzerland.
Emma Cloney, a nurse from Winnipeg, said she was diagnosed with lipedema, a connective tissue disorder which creates painful fat build-up, in the summer of 2021.
Cloney said Manitoba Health and Seniors Care initially approved funding for her treatments but cut her off after her third surgery. She said the province stopped her funding without prior notice.
"Without warning or medical advice, they made a policy decision to renege coverage," she told CBC News.
One medication alone costs her almost $500 per month and her medical expenses for the past year — including an international trip for surgery — amounted to over $55,000.
"Nobody should have to decide, will I buy groceries? Or will I take my medications? Which medications do I do without?" she said. "And I think for those of us living on fixed incomes, it's especially upsetting and it causes a lot of anxiety."
Cloney said she feels a deep sense of frustration when she sees little being done to make medication more affordable.
"There is so much chatter and bureaucracy around giving access to health care to people that there is a total lack of action."
Herder said the board has to be independent to make decisions without outside interference.
"We have to remain the master of our guideline. Certainly, there can be no interference," he said.
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