May 28, 2020 Table of Contents Research Health Minister’s oce says it is willing to “adjust timing and enforcement” of regulations in light of COVID-19 Health experts encouraged by Ontario premier’s call for national standards in long-term care Upcoming Events Webinar: “Accelerating innovation in healthcare for economic recovery” News Narrow focus to supporting ‘subpopulations,’ says expert, in preparation for second wave of the pandemic Press Releases Plan Canada Canadian Medical Association Pauktuutit Inuit Women of Canada New Democratic Party of Canada Committee Meetings June 3 – Senate Standing Committee on Social Aairs, Science and Technology May 28, 2020 RESEARCH Health Minister’s oce says it is willing to “adjust timing and enforcement” of regulations in light of COVID-19 RESEARCH EXCLUSIVE | MAY 28, 2020 With one month to go until new drug pricing rules are in place, Health Minister Patty Hajdu’s (Thunder Bay—Superior North, Ont.) ofce has told Hill Times Research that it is looking at all regulations to see if adjustments in timing need to be made as the federal Liberals govern during a pandemic. “As part of our response to COVID-19, we are looking at our approach to regulations to ensure that we adjust timing and enforcement as necessary,” said the email statement sent on May 28. This was in response to a Hill Times Research question regarding whether new rules governing the pricing of medicines will be in effect on July 1, 2020, which is the date set in the regulations. The statement did not specically mention the new PMPRB regulations. The regulations that will change how the Patented Medicine Prices Review Board regulates drug prices in Canada have pitted patient groups and pharmaceutical manufacturers against the Liberal government, who has said the changes would lower prescription drug prices. Those who are opposed to the new rules say they will result in fewer new medicines coming to Canada. Rumours swirl over when the new rules will come With the implementation date drawing closer, rumours have been circling that there may be a delay to the new rules being in effect. Conservative health critic Matt Jeneroux (Edmonton Riverbend, Alta.) told Hill Times Research on May 14 that he has heard that a delay is possible from people who follow the pharmaceutical industry. Jeneroux has recently spoken against the changes and, through a letter to Hajdu, asked that the new rules not be implemented for six months. He said in a phone interview that, after COVID-19, the most popular issue constituents and organizations want to discuss is the PMPRB changes. “We’re hoping that [a delay] gives more of an opportunity for these patient groups to get in front of the minister and the decision makers, and hopefully make some of the regulatory changes that they would like to see,” Jeneroux said. Page 1 of 14 May 28, 2020 A consultant who is following the PMPRB process has also heard it is possible that the rules will be delayed, and told Hill Times Research the Health minister’s ofce seems to be choosing who they’re telling about a possible new date. “I don’t know what their game is,” the consultant said. Hill Times Research agreed not to name the consultant so this person could speak more freely. Vocal opposition from patient groups Patient groups including the Canadian Organization for Rare Disorders and the Best Medicines Coalition (BMC) have loudly opposed the changes. John Adams, chairperson for BMC, told Hill Times Research in April that “given COVID-19, now is not the time to take risky experiments in public policy which may delay access to breakthrough medicines.” The organization also added lobbyists to its federal lobbying registry le in March to help it get its message across to policymakers. Over the last six months, Cystic Fibrosis Canada has ramped up its lobbying efforts against the changes when it realized that a new drug that could treat up to 90 per cent of CF patients had been approved for sale in the United States, but that its manufacturer was not applying for approval to distribute in Canada. Vertex’s Trikafta avoids Canada The name of the drug is Trikafta and it is manufactured by Vertex Pharmaceuticals. Although the company has other CF medicines available in Canada, it said through email on May 20 that the new PMPRB rules “will limit the ability of Vertex and other manufacturers to launch future medicines in Canada,” and that it “urge[s] the Canadian government to reconsider their position.” Vertex has been public about its reasons for not bringing Trikafta to Canada. That did not stop Hajdu from saying in an interview on May 27 that the company’s position is “disconnected” from the changes that will affect the PMPRB. Hajdu made the statement after a question from Maclean’s journalist Paul Wells during the publication’s Live interview series. The 45-minute long discussion held online mainly focused on the Liberal government’s response to the COVID-19 pandemic. But Wells also asked about Trikafta, saying he had received a question about the drug from a student with CF and Wells was told that the new pricing rules were the reason Trikafta would not be available in Canada. “That information is different than what I have,” Hajdu said, referring to the premise of the question that the new regulations are why Trikafta is not coming to Canada. “Yes, for sure, the company has not applied to sell the drug in Canada, but it’s actually disconnected from the PMPRB so we Page 2 of 14 May 28, 2020 drug in Canada, but it’s actually disconnected from the PMPRB so we anticipate that, we hope that they will apply to sell the drug in Canada.” Hajdu then went on to discuss how patients who would benet from the drug could apply to Health Canada’s special access program, with a letter from their physician. The program is a way for patients to access drugs that are unavailable in Canada. Hill Times Research reached out to Hajdu’s ofce on May 28 for an explanation of the discrepancy between her statement and public statements made by Vertex on the subject. Hajdu was specically asked why she is saying that Vertex’s decision not to apply for Canadian approval for Trikafta is not due to the PMPRB changes when the company states otherwise. “We made changes to the rules regulating the maximum prices of patented medicines to improve affordability and access to medicines for Canadians. The data shows that most new medicines are launched more quickly in countries that have lower prices than Canada – including the Netherlands, Sweden, the United Kingdom and Norway. It is up to the company to make the decision about whether or not they want to seek approval in Canada,” the ofce responded by email on May 28. Vertex Pharmaceuticals was asked if there was another reason aside from the PMPRB changes that it was not bringing Trikafta to Canada. “The only reason Vertex has not submitted [Trikafta] to Health Canada is because of the ongoing uncertainty created by the PMPRB pricing reforms. There is no other reason,” said Christina Cunningham, a spokesperson for Vertex Pharmaceuticals, through an email to Hill Times Research on May 28. Health experts encouraged by Ontario premier’s call for national standards in long-term care RESEARCH EXCLUSIVE | MAY 28, 2020 After a damning military report on the state of ve long-term care (LTC) homes in Ontario, the province’s Progressive Conservative premier has said he wants to see a national standard operating procedure across the country. "We need a system standard, as I say, an SOP, standard operating procedure, that applies right across the country, no matter if it's in Quebec or Ontario or B.C. We need a system that everyone goes by," Doug Ford said during a press conference on May 26. The report was produced by military members who were sent into ve LTC Page 3 of 14 May 28, 2020 The report was produced by military members who were sent into ve LTC homes that required extra stafng support during the pandemic. It was submitted to the federal government, which then shared it with the Ontario government this past weekend. Soldiers witnessed a “culture of fear to use supplies,” because of the cost; infected patients sharing rooms with those without symptoms; and “gross in-adherence” to orders requiring that patients’ vital signs be checked, among other allegations, as reported by The Hill Times. Ford’s comment on introducing a national system of some sort is encouraging, according to Laura Tamblyn Watts, CEO at CanAge, a national advocacy organization representing seniors. “I think Canadians are tired of the jurisdictional nger-pointing, [of politicians] saying ‘it’s not our responsibility.’ What this indicates really from a Conservative Ontario premier is that there is a willingness to work together,” Watts told Hill Times Research by phone on May 27. “Putting some of those jurisdictional measures aside, to hear the prime minister [say] that they will step in and be a part of that conversation and part of that solution sets the stage for us [at CanAge] to be able to push to say we do need national standards and we do need reform in long-term care,” she added. Watts recently registered on the federal lobbyists registry to discuss seniors’ care with federal ofcials. In addition to calling for a “system standard,” Ford said the province would need federal help in order to x the system, as long-term care is too big for the provincial government to handle alone.