Lauren Vogel | CMAJ | Feb. 21, 2017

Parliamentarians debated the impact of a European trade deal on drug prices, legislation to streamline approval of safe-injection sites, and measures to combat genetic discrimination in recent sittings of the House of Commons.

Canadian-European trade

Legislation to implement the Canadian-European Comprehensive Economic Trade Agreement (CETA) passed third reading in the House, despite opposition from New Democrat (NDP) members who warned that proposed changes to intellectual property rules would increase the cost of medicines.

It’s estimated that longer patent protection under Bill C-30 would increase drug costs by $2.8 billion a year, said Alexandre Boulerice, NDP member for Rosemont–La Petite-Patrie. “That will have a huge impact on the people who need those drugs and who do not have good private insurance,” he said. Higher prescription drug costs may also knee-cap efforts to bring in “much-needed universal pharmacare,” said Richard Cannings, NDP member for South Okanagan–West Kootenay.

Liberal and Conservative members argued that the economic benefits of CETA outweigh the costs. “It offers the opportunity of creating more jobs, and the potential for high-skill jobs in our country,” said Robert-Falcon Ouellette, Liberal member for Winnipeg Centre. Arnold Viersen, Conservative member for Peace River–Westlock, argued that the deal may also “increase the options for different kinds of drugs,” so even if a generic version of a particular drug is delayed there may be new alternatives.

The bill is now before the Senate and will likely become law without substantial amendment. During a Feb. 16 sitting, independent senator André Pratte said some European countries pay less for drugs than Canada, even though they have stronger patent protection. “Factors other than the patent protection are therefore in play,” and Canada can look for “other ways to make prescription drugs more affordable.”

Safe-injection sites

The House passed Bill C-37 to simplify applications to open supervised drug consumption sites. The bill, which also passed first reading in the Senate, would replace the former Conservative government’s 26-step process with five criteria. Under the proposed amendments, applicants would be required to demonstrate local need for a site, community consultation, the resources and administrative structure to support a site, and the impact on crime.

Supervised consumption sites are an essential part of harm reduction, said Health Minister Dr. Jane Philpott. “They save lives and improve health without increasing drug use or crime in surrounding areas.” The current checks on approval cause “unacceptable” delays, she said. It took a year and a half to approve three sites in Montreal.

Conservative members questioned the safety, efficacy and public safety of the sites. Other members were supportive, although NDP members urged the Liberal government to go a step further by declaring the overdose crisis a national emergency. “Such a declaration would empower Canada’s Chief Public Health Officer to take extraordinary measures to coordinate a national response,” including authorizing communities to open supervised consumption sites on an emergency basis, said Don Davies, NDP member for Vancouver Kingsway.

Philpott said the government already has “the authority to do what needs to be done.”

Genetic discrimination

Parliamentarians debated a Senate private member’s bill to prohibit discrimination on the basis of genetic test results. Bill S-201 would make it a criminal offense to require a person to take or disclose the results of a genetic test, or to collect or use a person’s genetic information without their consent, as part of providing goods and services or as a condition of a contract.

Currently, there are no federal or provincial laws that protect Canadians against genetic discrimination, particularly by employers or insurers. “Increasingly, and rightly so, patients are reluctant to agree to have their medical genetic testing done for fear the results may be used against them,” said Rob Nicholson, Conservative member for Niagara Falls. He cited the recent case of a healthy 24-year-old who lost his job after testing positive for Huntington disease, although his symptoms would not manifest for decades. “Canada is the only G7 nation not to have protections in place for citizens like him,” Nicholson said.

The bill has won support across party lines; it’s already passed the Senate and second reading in the House. But in a surprising turnaround, some Liberal members proposed scrapping most of the bill, except for adding a general prohibition under the Human Rights Act. Other members argued this would render the law toothless. Prohibitions under the Human Rights Act “only apply to federal matters,” said justice committee chair Anthony Housefather. “This would leave the vast majority of Canadians unprotected.”

Health Accord

Don Davies, the NDP member for Vancouver Kingsway, questioned whether the Liberal government would still attempt to strike a pan-Canadian health accord with the provinces. “After the last election, there was hope that we would see a renewed collaborative approach to health care funding, but 18 months later, all we have seen is a divide-and-conquer tactic,” he said. Six provinces have cut side deals with the federal government since accord negotiations failed; Ontario, Alberta, Manitoba and Quebec are still holding out for a pan-Canadian agreement with a bigger annual increase in federal funding than the 3.5% escalator proposed by Ottawa.

Health Minister Dr. Jane Philpott responded by reiterating the government’s final offer for a new accord. “We will increase the Canada health transfer every single year … and offer to invest $11.5 billion” for shared priorities, such as mental health.

Organ donation

Members heard two petitions to improve Canada’s organ donation system by making it easier for Canadians to register as donors by answering a simple question on their annual tax return. Currently, 90% of Canadians support organ donations, but only 25% are registered.

 


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