Patented Medicine Price Review Board hearings show public pharmacare best option to lower the cost of drugs

Nikolas Barry-ShawWho would have thought that the internal working of an obscure federal regulator with a tongue-twister of an acronym (PMPRB, short for the Patented Medicines Price Review Board) would explode so spectacularly in the faces of the Liberals? Certainly not health minister Jean-Yves Duclos.

When Duclos intervened to delay long-awaited pricing guidelines for prescription drugs in November 2022, he probably expected the move to go as unremarked as it had the previous times. It was, after all, the fifth time the reforms were delayed since they were first introduced in 2017.

Yet a string of high-profile resignations at the drug price regulator and incriminating emails obtained by journalist Kelly Crowe showing collusion between the Minister, his staff, and pharmaceutical industry lobbyists landed the health minister in the hot seat.

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And rightly so. Recent hearings by the Standing Committee on Health into the Minister’s action vis-à-vis the federal drug price regulator have not painted a pretty picture. The Health Minister comes off as little more than an errand boy for the powerful pharmaceutical industry he is tasked with regulating.

In the midst of an ongoing cost-of-living crisis, one would think that the Liberal government would be scrambling to show they are doing something to alleviate people’s pain. Lowering drug prices – Canada has some of the highest in the world – would seem like an obvious priority, one that would save people and the health care system money and, more importantly, lives.

As recently as 2019, the Liberals were touting the PMPRB changes as “the biggest step to lower drug prices in a generation.” Indeed, up until a few months ago, some Liberal MPs were still citing the unaccomplished reforms as proof that they were doing something about high drug prices in communications with constituents.

Testifying before the committee on May 2nd, former PMPRB board member Matthew Herder did not mince words. “The question we should all be asking is when will we ever stand up to industry’s power and take the steps that are needed to make medicines more affordable for Canadians.”

That question is especially urgent when it comes to pharmacare, legislation for which the Liberals insist is coming despite the recent budget containing not a word about it. Public, universal pharmacare has the potential to generate savings significantly larger than the ill-fated PMPRB reforms: $5 to $11 billion in savings for Canadian households, employers, and our health care system per year, rather than $3 billion per decade.

In the hands of a minister so deeply in the pocket of industry, pharmacare risks becoming a shadow of what was outlined in the Advisory Council on Implementing National Pharmacare. Rather than a public, single-payer system that ensures everyone has coverage, we could get another patch or two added to our inadequate patchwork system of public and private payers.

That was one of the lessons of the Hoskins’ report that seems to have been forgotten: if we pay too much for drugs in Canada, it is precisely because this fragmentation of our purchasing power allows Big Pharma to charge what they want. Other countries use their collective purchasing power to negotiate lower prices. In Canada, the PMPRB is the only bulwark we have against abusively high prices, and it has proven to be quite ineffectual.

The stymieing of efforts to reform the PMPRB makes getting public, universal pharmacare right all the more important. Only under a public, single-payer system will we be able to bring drug prices back to earth. And that’s why Big Pharma is fighting it tooth and nail. But unlike the obscure and technocratic PMPRB, pharmacare continues to be a proposition that the country and across political and demographic lines support.

Nikolas Barry-Shaw works at the Council of Canadians, campaigning for public, universal, comprehensive pharmacare for everyone in Canada. Learn more at

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