Health minister disputes claim he sided with big pharma, interfered with drug price consultations

Health Minister Jean-Yves Duclos is pushing back against claims that he interfered with the work of Canada's pharmaceutical pricing agency by asking it to delay reforms intended to bring down the price of patented drugs.

The allegations stem from a report in The Breach that said Duclos and associate assistant health deputy minister Eric Bélair sent letters to the Patented Medicines Price Review Board (PMPRB) late last year asking it to suspend the consultations it was holding on proposed guidelines for pricing. 

"PMPRB is a totally independent organization. It is not subjected and it will never be subjected to political interference," Duclos said Wednesday in Mississauga, Ont.

"They asked for my view as a health minister … I invited them to do the right amount of consultation so that this would be done in the more proper and most efficient and most speedy manner possible."

Duclos' comments follow a series of high-profile resignations at the PMPRB. They include its executive director Douglas Clark, board member Matthew Herder and former acting chair of the board Melanie Bourassa Forcier.

Herder posted online his three-page resignation letter, addressed to Duclos. In it, he said that while he enjoyed sitting on the board for the past five years, he was quitting over a 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 a social media post, Forcier said she's looking at her legal obligations before deciding whether she can share the reasons for her resignation. In the release announcing his departure, Clark did not mention recent discord between the PMPRB and Health Canada.

In 2016, the federal government announced that it would protect Canadians from excessive drug prices by launching consultations on proposed amendments to patented medicine regulations.

The PMPRB was tasked with consulting industry and other stakeholders and coming up with regulations. A group of drugmakers challenged those regulations. In February of last year, the Quebec Court of Appeal sided with the pharmaceutical industry, leaving only one regulation intact.

That surviving regulation changed the list of countries Canada uses to determine if its drug prices are too high. The court concluded that instead of comparing Canadian drug prices to the OECD median, they should be measured instead against a list of 11 comparable countries that excludes the U.S. and Switzerland, which have some of the highest drug prices in the world.

Herder said one of his reasons for resigning from the board was the federal government's failure to appeal that ruling to the Supreme Court of Canada.

"The net result is that only one element of the regulations remains good law — a far cry from what the government described as the 'biggest step to lower drug prices in a generation' when the new regulations were first enacted," Herder wrote. 

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

Hitting pause

Duclos wrote to the PMPRB in November asking it to suspend consultations on the country list comparison, effectively delaying the regulations.

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

In his resignation letter, Herder took issue with the requests from Duclos and Bélair to pause the consultations.

"Your request in late November that we suspend our consultations for reasons that were largely indistinguishable in form and substance from industry taking 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 the federal government over what he said were four separate delays to the introduction of the new regulations.

"The government accepted, again and again, industry's claim that it needed more time to comply with the new regulations," he wrote.

The federal government says that even without the regulations tossed by the Quebec Court of Appeal, pricing drugs at the median cost across the group of 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," Duclos said.