Trudeau’s health minister accused of advancing ‘special interests’ by delaying drug reforms

A former board member criticized Ottawa for delaying new regulations at the recommendation of the pharmaceutical industry.

Trudeau’s health minister accused of advancing ‘special interests’ by delaying drug reforms
Jean-Yves Duclos/ Twitter
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A former board member of Canada’s drug price regulator continues to accuse the health minister of delaying meaningful price reforms, which led to several resignations.

According to a report in The Breach, Duclos and associate assistant health deputy minister Eric Bélair drafted letters to the Patented Medicine Prices Review Board (PMPRB) last year asking the body to suspend consultations on proposed pricing guidelines — a move that policy experts claim could permanently derail the process.

Bélair's submission said Health Canada wanted to "pause the consultation process" to give stakeholders and partners time to "fully understand the short and long-term impacts of the proposed" guidelines.

Matthew Herder, one of the former board members, took issue with the request.

"Your request in late November that we suspend our consultations for reasons that were largely indistinguishable in form and substance from industry talking points on the proposed guidelines undermined the board's credibility and interfered with the exercise of a function that goes to the very heart of its expertise as an independent, arms-length administrative tribunal," he wrote.

Around the same time, Innovative Medicines Canada, a pharmaceutical advocacy group, appealed similarly, asking the PMPRB to pause the consultation process and “fundamentally reconsider” the guidelines.

It’s unusual for health ministers to make such requests of the PMPRB, as the move led to the resignation of two board members and its executive director.

"PMPRB is an independent organization. It is not subjected and will never be subjected to political interference," said Duclos in a statement last month.

"I invited them to do the right amount of consultation...properly, efficiently, and speedily."

“It felt like we have been in a tunnel for a long time,” said Herder on their efforts to cap medication prices. 

The PMPRB contends these guidelines help interpret and enforce the regulator’s new drug price rules. The public consultation was to conclude on December 5 and come into force this January 1.

In his three-page resignation letter, addressed to Duclos, Herder explicitly disapproved of the lack of government support for needed reforms.

"The last thing I want to do is hurt the organization," he wrote. "However, in the absence of the political courage to support meaningful policy reform, the position of the PMPRB has become untenable."

In 2016, Ottawa pledged protections for Canadians from excessive drug prices. They tasked the PMPRB with launching consultations with the industry and stakeholders on proposed amendments to patented medicine regulations.

However, a group of drugmakers in the Quebec Court of Appeal challenged them last year and ruled favouring the pharmaceutical industry. Only one regulation remained intact — to amend the list of countries Canada compares its drug prices to gauge their affordability.

The court concluded that instead of comparing prices to the OECD median, they should be measured against a list of 11 comparable countries excluding the U.S. and Switzerland, which have some of the highest drug prices worldwide.

Still, Herder cites not appealing the ruling to the Supreme Court of Canada as a reason for him tendering his resignation from the PMPRB.

"In choosing not to seek leave to appeal, the government effectively [eviscerated] its reform," he wrote.

The former board member also criticized Ottawa for four separate delays in introducing new regulations at the recommendation of the pharmaceutical industry.

“[After the minister requested that we suspend the review process,] we just felt like there was no light at the end of the tunnel anymore,” said Herder, who describes the Health Ministry’s involvement as “inappropriate interference…to obfuscate the truth.”

In a statement on Thursday, the Health Ministry claimed the regulator board chair never provided Duclos with a formal briefing on the matter, refusing to comment specifically on the suspension, citing the Patent Act. 

The PMPRB made repeated attempts using multiple channels to reach the minister. Still, the former board member said their efforts were either “met with silence” or initially responded to but never received a follow-up.

“Either way, we weren’t getting a meeting,” said Herder, adding that that’s why the suspension request in November came as a shock to the PMPRB board.

“A request becomes a demand when there’s been no conversation. I would say the request crossed a line because there had been no dialogue.”

Despite minimal interaction with the PMPRB, records from the federal lobbyists' registry revealed the health minister and his staff met with representatives from pharmaceutical companies at least a dozen times last fall to lobby on various issues, including the drug-price guidelines.

“This is the only minister of health to be appointed under the Liberal government who has not had a briefing on proposed changes to our guidelines,” claimed Herder. 

“To make such a request, after having no back and forth, after hearing from the industry that they would make the same request, it starts to feel like this is the product of very powerful interests pushing the minister for this outcome.”

Next month, the House of Commons health committee will study the recent events involving the PMPRB.

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