Health committee  There is one study, among others, that was done by the U.S. Government Accountability Office, which revealed that in the United States, before user fees were charged in 1992, 1.6% of drugs were taken out of circulation. User fees have meant that the approval time has been cut in half.

Health committee  Anyhow, in Canada there are ways of having access to experimental drugs. Suppose someone has HIV and all the drugs he has taken up to now are not working anymore. If a new drug arrives on the market and is promising, even though it may also have undesirable effects, that we do not know everything about, if the person, who is in the terminal phase or about to die, wants to try it out, I do not think we can stand in his way.

Health committee  This would indeed by desirable, if only for the sake of efficiency. If such an agency is created, it will have much greater negotiating power, provided it is given negotiating power. I know that the RAMQ, for example, does not have the power to negotiate with the pharmaceutical companies.

Health committee  I am not sure where to begin, but I want to take the example of a cancer drug called Iressa. I went to the Health Canada site, among others, which are quite good with regard to the undesirable effects of drugs. This is a drug used for lung cancer. Now it is also being used outside of indications to treat such things as neck and head cancer.

Health committee  It is true, for instance, that New Zealand has two cholesterol lowering drugs, while Quebec now has six. New Zealand has always refused to approve Celebrex and Vioxx, because their superiority over traditional anti-inflammatories has never been demonstrated, and also because, right from the beginning, it was suspected that Vioxx could cause cardiovascular problems.

Health committee  —of drugs in British Columbia was attributable to the introduction of new products or new indications that contribute nothing or little in therapeutic terms. These products, which are called me-too products, are equivalent molecules to those already found on the market. The efficacy of these new indications is often not tested in the field.

Health committee  Thank you, Mr. Chair. Good afternoon, ladies and gentlemen. I wish to thank the members of the committee for giving me this opportunity to address them. You will find all the references at the end of my text. By way of introduction, I will say that drugs account for 17.5%—

Health committee  Drugs accounted for 17.5% of health expenditures in 2005, a substantially higher percentage than that paid to physicians. Drug expenditures have become the most inflationary component in our system and they are increasing twice as fast as the health budget as a whole. Furthermore, in Canada, almost twice as many prescription drugs are prescribed as in the Netherlands and Denmark – even though the major health indicators are practically identical in these three countries.