Trudeau's health minister accused of delaying drug pricing reforms

The Canadian Press / Adrian Wyld

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According to a report in The Breach, Duclos and associate assistant health deputy minister Eric Bélair drafted letters to the Patented Medicines Price Review Board (PMPRB) last year asking the body to suspend consultations on proposed pricing guidelines. 

"PMPRB is an independent organization. It is not subjected and will never be subjected to political interference," said Duclos, who claims they asked for his view as federal health minister.

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

Duclos' remarks come amid several high-profile resignations at the PMPRB, including its executive director Douglas Clark, board member Matthew Herder and former acting chair of the board, Melanie Bourassa Forcier.

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Herder posted his three-page resignation letter, addressed to Duclos, explicitly stating he 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."

Clark did not reference the recent discord between the PMPRB and Health Canada in his resignation disclosure. Forcier added she's reviewing her legal options before commenting publicly on her resignation.

In 2016, the federal government 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.

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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 Ottawa's failure to appeal that ruling to the Supreme Court of Canada as a reason for his resignation from the PMPRB.

"In choosing not to seek to leave to appeal, the government effectively countenanced the evisceration of its reform," he wrote.

The federal government contends that drugs at the median cost across 11 countries would have saved Canadians $2.8 billion in 2018.

"Drug prices and, in particular, patent drug prices in Canada are among the highest in the world next to the United States and Switzerland, and that's why we have committed to reducing the cost of those drugs in Canada," said Duclos.

Herder claimed the net result of "government inaction" is far from what they described as the 'biggest step to lower drug prices in a generation' when they first enacted the new regulations.

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Duclos wrote the pharmaceutical pricing agency in November, asking it to suspend consultations on the country list comparison.

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

Herder took issue with their requests.

"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.

Herder also criticized them for four different delays in introducing the new regulations at the recommendation of the pharmaceutical industry.