Minister of Health Jean-Yves Duclos looks waits to appear at the Health committee in Ottawa, on April 27.Adrian Wyld/The Canadian Press
Two former insiders at Canada’s drug price regulator testified Tuesday that interference from federal Health Minister Jean-Yves Duclos raised questions about the government’s closeness to the pharmaceuticals industry and jeopardized efforts to control spiralling prescription drug prices.
Douglas Clark, the executive director of the Patented Medicine Prices Review Board, told the House of Commons health committee on Tuesday that he was taken aback when Mr. Duclos sent a letter in November asking the agency to suspend its public consultations on price reforms. Mr. Clark said such a suspension was “precisely what the industry had called for.”
“To say that I was surprised by that letter would be an understatement, and its content was of grave concern to me, my senior staff and our general counsel,” Mr. Clark said. It was his first public statement since announcing his resignation in February. He will remain executive director until June 1, but is on leave from the role.
Mr. Duclos told the committee last week that he was obligated to ask the PMPRB to consider suspending the consultation to ensure he and other stakeholders could take the time to understand its ramifications. He has said the letter was not an order. Nevertheless, the PMPRB suspended its consultation soon after receiving it.
The PMPRB, an independent quasi-judicial board, has been working for several years on changes to rein in the escalating cost of brand-name drugs. Public health plans, which account for 44 per cent of prescription spending in Canada, spent $16.2-billion on drugs in 2021, a 7.4-per-cent increase from the year before.
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The proposed changes have been opposed fiercely by pharmaceutical companies and patient groups, which argue the reforms would harm innovation and keep important drugs out of Canada. Mr. Clark told the committee he believes the government opposes the PMPRB’s plans for similar reasons.
The changes have been watered down and delayed several times. They would finally have come into force in January with the implementation of new guidelines. But Mr. Duclos’s letter in November appears to have stalled the process indefinitely.
Matthew Herder, who resigned his post as a PMPRB board member in February, told the House of Commons health committee that Mr. Duclos’s decision to intervene personally “is an arrow straight to the heart of the board’s supposed independence.”
“Industry now knows that it can bypass the PMPRB when it isn’t satisfied with the board’s policy direction and get the minister to do its bidding,” Mr. Herder told MPs.
Mélanie Bourassa Forcier, who resigned from her role as the PMPRB’s acting board chair in December, told committee members last week she did not believe Mr. Duclos had interfered in the process. She said she agreed the board had to take more time to consult with stakeholders.
Mr. Duclos has said he had the ability to ask for the suspension because the Patent Act requires PMPRB officials to brief him before any new guidelines are issued.
But Mr. Clark testified that five separate attempts to set up a briefing were met with silence.
Mr. Clark, who has served as executive director for nearly a decade, also told MPs that he regularly met with previous federal health ministers and that typically such requests to meet came from ministerial staff, not from the PMPRB.
In response to an interview request, Mr. Duclos’s office sent a statement that said the minister “does not provide direction to the PMPRB” and that he had never received a formal invitation from the PMPRB to participate in a briefing.
In his testimony, Mr. Herder said the minister’s letter, which was delivered after weeks of silence and days before the consultation period ended, seemed to be more than a mere suggestion.
“There were multiple attempts to reach his office and the answer back was silence,” he said. “That’s why it came across as more of a demand than a request. It was incredibly divisive inside the board so it absolutely interfered with our work in my view.”
During Tuesday’s committee hearing, NDP health critic Don Davies asked Mr. Clark what he made of the fact that Mr. Duclos and his staff had met with lobbyists from the pharmaceutical industry more than a dozen times during the consultation period last fall, but did not meet with the PMPRB.
“The government is quite intent on attracting investment in domestic manufacturing capacity in the event of a future pandemic. I think it’s also pretty clear that the PMPRB reforms are the fly in the ointment in those efforts,” Mr. Clark responded. “The imperative of smoothing out relations with the industry trumped any consideration of whether the guidelines were sound policy or had merit.”
Mr. Davies asked Mr. Clark why the minister would have requested the PMPRB suspend its consultation process, rather than extend it, if he wanted more consultation with stakeholders.
“That is question that baffles me to this day,” Mr. Clark said.