Drug-price regulator sought meetings with health minister to discuss reforms, documents show

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Canada’s drug regulator repeatedly asked to meet with Health Minister Jean-Yves Duclos to brief him on proposed drug price reforms last fall, but the requests went unanswered, newly released documents show.

The documents, posted online Tuesday after a request from the House of Commons health committee, indicate Mr. Duclos’s staff did not respond to those requests or never followed up on them, so a briefing with the Patented Medicine Prices Review Board (PMPRB) never took place during a public consultation on those proposals.

But on Nov. 28, one week before the consultation closed, Mr. Duclos wrote a letter to the PMPRB’s acting chair, Mélanie Bourassa Forcier, suggesting the agency “consider suspending the consultation process,” in part because of its failure to consult with him. (The letter was in French, so the partial quote is a translation.)

The letter is at the heart of an investigation by the health committee, launched earlier this year at the request of NDP MP Don Davies, who alleged Mr. Duclos interfered with the independence of the drug regulator when he asked Prof. Bourassa Forcier to suspend the consultation.

Mr. Duclos has denied acting inappropriately, and his office declined to comment on the newly released documents when asked by The Globe and Mail.

In the days and weeks after receiving the letter, the PMPRB board became divided over how to respond, which led to the resignation of Prof. Bourassa Forcier. The absence of a board chair forced the PMPRB to suspend the consultation process, raising questions about whether the reforms would ever be implemented. In February, board member Matthew Herder and executive director Douglas Clark announced separately that they too were resigning.

Mr. Duclos has defended his actions numerous times, including before the health committee in April, saying his request that the PMPRB suspend its work was made because the chair had not formally invited him to a briefing and that, as a result, the consultation was insufficient.

“Had I received an invitation, I would have gladly met with the board,” he told the committee.

But the newly released documents show that Mr. Clark e-mailed, called and texted members of Mr. Duclos’ staff during the public consultation last fall to set up a meeting to go over the proposed changes and discuss how they would affect drug pricing.

Mr. Clark e-mailed Mr. Duclos’ chief of staff, Jamie Kippen, on Nov. 9, offering to brief him or the minister. Mr. Kippen said he would “loop back,” but Mr. Clark wrote in a note on the documents that he never heard back.

On Nov. 17, Mr. Clark called Jean-Sébastien Bock, the minister’s senior director of policy, and was told by a receptionist that he was busy and would call back. Mr. Bock did not return the call, so Mr. Clark tried again several hours later. The receptionist asked Mr. Clark what the call was about, and when he said “the PMPRB guidelines,” the receptionist said Mr. Bock would not take the call.

The day after Mr. Duclos sent the letter asking the board to suspend its work, Prof. Bourassa Forcier texted the director of the board secretariat to request a meeting with the minister. Secretariat Sherri Wilson replied that meeting requests typically go to the deputy minister because “we are required to follow the chain of command as public servants.”

In a text message exchange between Prof. Bourassa Forcier and Mr. Clark on Nov. 29, she repeated her wish to meet with Mr. Duclos directly. Mr. Clark replied that he had spoken to a “very connected person” that morning and that the minister’s office wanted the PMPRB “to go away and the members resign of their own accord, since they can’t fire them.”

The documents also show that Prof. Bourassa Forcier was the only board member who wanted to heed Mr. Duclos’ request to suspend the consultation. The rest of the board members disagreed, which ultimately led her to resign as acting chair.

She submitted documents to the health committee stating that Mr. Duclos’ letter made her concerned that the consultation process had been inadequate and that she wanted to do whatever was necessary to hear from all stakeholders.

The documents include a series of e-mails between PMPRB staff in the days after receiving Mr. Duclos’ letter in which they note that it was the first time they had heard any concerns regarding the new guidelines, which were supposed to come into force on Jan. 1, 2023.

The e-mails say PMPRB staff members met with Health Canada officials seven times throughout the fall to discuss the new guidelines. In an April 7 e-mail, PMPRB policy director Tanya Potashnik wrote that “at no time” did Health Canada suggest making any changes, which is one reason why Mr. Duclos’ letter was so unexpected.

“Thus, I would have to say, for me, given the number of meetings we did have, the formal feedback received in the form of the letter came as a surprise, given the ample opportunity during the consultation period to express their views,” she wrote to Mr. Clark.

The existence of Mr. Duclos’ letter only came to public attention in February, after online media outlet The Breach received it as part of an access-to-information request.

The newly released documents include a number of e-mails between Health Canada and PMPRB staff about the possible disclosure of the letter. In one, dated Feb. 13, Louis Roy, Health Canada’s access-to-information team leader, said there were “concerns” in the department about the letter and other documents being released.