Question Period Notes
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Recent media articles have reported that drug shortages in Canada are worsening, highlighting current shortages of cancer drugs, and concerns voiced by healthcare professionals and patients unable to access supply.
What action is Health Canada taking to address drug shortages?
The media and stakeholders have raised concerns regarding caffeinated energy drinks (CEDs). In October 2019, the Radio-Canada weekly TV series Enquête aired a program focusing on the risks associated with the consumption of these products, particularly among children, teens, and individuals with pre-existing cardiac health conditions. A segment of the program discussed the deaths of 15-year old Brian Shepherd (2008) and 21-year old Zachary Mitchell (2016). Shortly after the program aired, the Quebec Minister of Health announced that the province is considering banning the sale of CEDs to individuals under the age of 16 years old.
• What is the Government of Canada doing to protect children and teens from the risks associated with caffeinated energy drinks?
A shortage of EpiPen (0.3 mg) auto-injectors is currently being reported in Canada with an unknown end date. EpiPen Jr (0.15mg) is not impacted by this shortage. EpiPen is used to deliver an emergency treatment of adrenaline (epinephrine) to patients who are at risk or have a history of serious life-threatening allergic reactions (anaphylaxis). While Health Canada has authorized other epinephrine auto-injector products, they are not currently being marketed in Canada.
What is Health Canada doing about the shortage of this critical drug?
Rare diseases are life-threatening, seriously debilitating and sometimes chronic in nature. There are generally few or no treatment options, which means any available treatment is in high demand and can command significant prices (e.g., $100K to upwards of $2M per patient per year). These high prices combined with the increasing prevalence and severity of rare diseases, pose significant challenges to patients, caregivers, and the health care system, including the sustainability of public and private drug plans that pay for these drugs
• What is the Government doing to improve access to drugs for rare diseases and address the high cost of these drugs for Canadians living with rare diseases?
On April 28, 2017, Health Canada’s Pest Management Regulatory Agency (PMRA) published its final re-evaluation decision document for pesticides containing glyphosate, allowing its continued use in Canada (marketed under brand names such as Roundup and Vision). Glyphosate is the most widely used pesticide globally.
Subsequently, eight Notices of Objection (NoO) were filed by stakeholders requesting reconsideration of the glyphosate decision. Following a review of stakeholders’ concerns, the Department confirmed on January 11, 2019, that issues raised in these NoOs were not scientifically supported. Therefore, the Department’s final re-evaluation decision for glyphosate stands.
Media and stakeholder interest remains high, following three court decisions in the United States which awarded large settlements to individuals who claimed their cancer was caused by glyphosate. In Canada, a number of class action lawsuits have been proposed linking non-Hodgkin’s lymphoma and exposure to glyphosate. The lawsuits have yet to be certified as class actions.
Some of the information referenced during the US trials and proposed legal action in Canada (known as the “Monsanto Papers”) raised concerns around the independence of some science reviews with respect to glyphosate. These concerns were addressed by Health Canada through the Notice of Objection (NoO) process, which included a thorough review of information.
• Given the allegations about Monsanto, and the proposed class action lawsuits in Canada, why is glyphosate still approved for use?
Exposure to lead can lead to effects on neurological development and behaviour in children.
Lead in drinking water has received media attention across Canada. Multiple media outlets have reported “hundreds of thousands of Canadians could be consuming tap water laced with high levels of lead leaching from aging infrastructure and plumbing”. The findings are the result of a year-long investigation by more than 120 journalists from nine universities and 10 media organizations.
Two Canadian scientists, from Simon Fraser University and Université de Montréal, have also written an opinion piece calling for Canada to develop a single health-based national water quality standard to protect Canadians against the harmful effects of lead in drinking water.
In March 2019, Health Canada published the updated Guidelines for Canadian Drinking Water Quality for Lead, which lowered the maximum acceptable concentration from 0.01 mg/L to 0.005 mg/L.
• What is Health Canada doing to protect the health of Canadians from the effects of lead in drinking water?
In June 2017, federal and provincial assisted dying legislation were challenged in a Quebec Superior Court by two individuals (Truchon/Gladu) who claimed that the Criminal Code of Canada requirement that an individual’s natural death be reasonably foreseeable and the provincial requirement for a person to be at the end of life were in violation of the Charter of Rights and Freedoms.
On September 11, 2019, the Quebec Superior Court ruled in favour of the plaintiffs and found both the federal and provincial criteria invalid. The effect of the judgement was suspended for 6 months (i.e., until March 11, 2020). The decision applies only in Quebec. If legislative changes are not passed prior to this date, there would be a difference in eligibility for MAID between Quebec and the rest of Canada.
On October 2019, the Government of Canada confirmed that it would not appeal the Quebec Superior Court’s decision. The Prime Minister has publicly indicated that the way forward requires legislative reform and that the Government is committed to making progress within the six-month timeframe set out by the Court.
• How is the Government going to respond to the Quebec Superior Court decision that declared the reasonably foreseeable death criterion as unconstitutional?
In recent years, most provinces (particularly Manitoba, Saskatchewan and Alberta) have seen a marked increase in methamphetamine use, including an increase in overdoses in which methamphetamine was involved. Two reports on methamphetamine issues in Canada were published in June 2019 – one by the House of Commons Standing Committee on Health (HESA) and one by the Manitoba Illicit Drug Task Force. Both reports highlight the increasing rates of methamphetamine use and harms in Canada. Reports by the media on the use of methamphetamine in the Prairie provinces have used terms such as “crisis” and “epidemic”.
• What is the federal government doing to address the increasing reports of methamphetamine use in Canada?`
The opioid overdose crisis continues to be a serious and unrelenting public health threat whose effects are being felt by people, families, and communities across Canada. In recent years, Canada has experienced an unprecedented increase in opioid-related overdoses. Between January 2016 and March 2019, there were 12,813 apparent opioid-related deaths across the country. Life expectancy in Canada has stopped increasing for the first time in over four decades; this is largely attributable to the opioid crisis.
• How is the Government addressing the opioid overdose crisis in Canada?
Budget 2019 will provide Health Canada with $36.5 million over five years, starting in 2019–20, with $5 million per year ongoing, to develop a pan-Canadian data and performance system for organ donation and transplantation, in collaboration with provincial and territorial partners.
According to the Canadian Institute for Health Information, in 2018 a total of 2,829 lifesaving transplants were performed in Canada (including Quebec), there were 4492 patients on organ waitlists, and 232 patients died while waiting for a transplant. At the end of 2018 there were 40,289 Canadians living with end-stage kidney disease, not including Quebec. (CIHI, 2019)
• What is the Government of Canada doing to improve organ donation and transplantation in the country?