2023-06-08 22:16:06
(OTTAWA) Internal email at the agency responsible for regulating the price of patented drugs in Canada shows that a letter from federal Health Minister Jean-Yves Duclos sparked the discord and division that led to resignations.
Such an atmosphere resulted in an indefinite pause on major drug price reforms and also led to resignations.
Emails released to the House of Commons health committee suggest some members of the regulator’s board believed the crisis following the minister’s letter threatened the very survival of the agency.
“We are experiencing a significant conflict that must be resolved to ensure the survival, integrity and continued business of the (Patented Medicine Prices Review Board),” former interim chair Mélanie Bourassa Forcier wrote to members. from the board on December 4, 2022. She resigned from her position the following day.
The emails show that the dispute began last November, when the Patented Medicine Prices Review Board (PMPRB) was consulting on the details of recently passed rules that would radically change the way drug prices are set in Canada.
Innovative Medicines Canada, a pharmaceutical lobby group, has requested a meeting to discuss its concerns on Nov. 18.
Minister Duclos wrote a letter to the interim president and suggested suspending the process to give pharmaceutical companies, patient groups, provincial ministers and himself more time to understand the changes.
“I respectfully request that the board consider suspending the consultation process, in order to work collaboratively, with all stakeholders, to fully understand the short and long-term impacts of the proposed new guidelines,” Duclos wrote. .
The letter was received with surprise by the independent agency, which until then believed the minister was on board with his plan, kicking off an intense 10-day pitch that ended concluded with the suspension of the new rules.
Minister Duclos’ request divides
While interim board chair Mélanie Bourassa Forcier favored the pause and meeting with the pharmaceutical lobby before the end of the consultation period, the rest of the board and chief executive Douglas Clark protested. .
Mr. Clark told Mr.me Bourassa Forcier that they should not argue with the minister.
“In fact, we should try to respectfully communicate that what he’s ‘asking’ is very problematic,” he said in a Nov. 30 email.
Mr. Clark also insisted that the minister had no intention of meeting with the board or the interim president.
“The most important thing right now is to protect ourselves. The minister wants nothing to do with us,” Clark said in a text message exchange with Ms.me Bourassa Forcier.
“They want us to leave and the members to resign of their own accord, since they can’t fire them. »
Minister Duclos has repeatedly denied exerting undue pressure on the review board.
M’s answerme Bourassa Forcier to Mr. Duclos did not include any commitment to suspend the consultation period, but she told the deputy health minister that she was open to the idea and would discuss it with the council.
“Making such a promise puts the three of us in a terrible position because if we don’t suspend as she has planned, the (deputy minister) probably suspects/knows that it is us who are preventing this,” said Board member Matthew Herder to fellow members in a Dec. 2 email.
Mr. Herder and the other two board members took a strong stance once morest the minister’s request, insisting that the consultations be completed in time and that the board then meet with Innovative Medicines Canada.
Mme Bourassa Forcier declared that it would be morally and professionally impossible for him, and explained that prolonging the consultation or meeting the pressure group beforehand would cost them nothing. She finished her response from 1is December with a warning: “If the Minister decides to get rid of the PMPRB, we will not achieve our objectives,” she wrote to the board.
Mr Clark scolded the interim chairwoman, following having had a “tough” conversation with the lobby group a few weeks earlier.
“If the Board decides to suspend consultations and make a public announcement to that effect, staff members will lose credibility with (Innovative Medicines Canada), and any future meetings between us will be window dressing at best, because Innovative Medicines Canada will know that if he hears something he doesn’t like, the minister will order the council to back off,” he wrote.
The situation evolved from there. Mme Bourassa Forcier said she was not comfortable refusing the minister’s request and that she did not understand why the council was so reluctant to extend the consultations.
She later told the health committee that she didn’t feel rushed by Minister Duclos’ letter and agreed that the agency should take more time to consult on the proposed change.
Personal attacks
The parties traded accusations of personal attacks, insubordination and negative effects on their mental health.
“I have never seen the head of an organization show such poor judgment and engage in such questionable ethical behavior in such a short time,” Mr. Clark wrote.
On December 5, the day the consultation period was to end, Ms.me Bourassa Forcier said the silence sent a message of confrontation that she was not comfortable with.
The rule changes, which would have come into force on 1is January, have been postponed indefinitely. MM. Clark and Harder announced their own resignations in February.
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