Health committee  As we shared with you, we are here today because we find the PMPRB consultative process to be ineffective. The feedback provided by not just us but patient organizations has been ignored, as is reflected in the number of significant increases in the number of negative submissions on the guidelines when you move from the initial consultative process to the August timeline.

Health committee  One thing we find as we are working with indigenous communities as well is that they are even more challenged with regard to optimal access during the time of COVID. Just this morning, for instance, I had a discussion with Greybox, which is a Quebec-based virtual technology digital platform, and an indigenous group concerning how we—Boehringer Ingelheim is partnering with Greybox—can bring Greybox into the picture with this indigenous group, which manages pan-Canadian optimization of diabetes care.

Health committee  Thank you for that question, honourable member. There's a process in place in Canada that has been in place for 10 years, which the provinces have implemented. It is called, as you are aware, the pan-Canadian pharmaceutical alliance. Boehringer Ingelheim was the first company that went through the successful negotiation on the pCPA process for a stroke prevention drug, the first drug in 50 years that demonstrated improving stroke outcomes.

Health committee  In any business, honourable member, you require certainty and predictability over a three- to five-year horizon. Introducing a drug in Canada requires investments in clinical trials. It requires more than just getting a Health Canada approval. What has happened with the PMPRB regulations is that they have impacted upon the predictability and the certainty of the business model, which is to ensure that beyond just introducing a product, we can ensure that the product supports clinical research on an ongoing basis and supports some of the kinds of initiatives, from a health system perspective, that we've spoken about and supports patient needs for the long term.

Health committee  Thank you for asking—

Health committee  No. If I could share with you, Mr. Davies—

Health committee  I will leave it up to Annie. Did you want to address that?

Health committee  I'm sorry. I was muted.

Health committee  Thank you for the question, honourable member. All you have to do is take a look at what's transpired since 2018 when the PMPRB guidelines were initially put out, from the perspective of clinical trials and from the perspective of new drug launches in Canada. Of 34 drug launches globally, 21 of those drugs have not been launched in Canada.

Health committee  The pharmaceutical industry plans long term—three to five years—in the clinical trials that we establish in any jurisdiction, in the kind of health system partnerships we establish in Canada, and in patient support programs to take care of patients who may fall between the gaps.

Health committee  I would say that, if you take a look at the submissions that the patient organizations have made—

Health committee  Thank you, Annie. Thank you, Mr. Chair, and honorary members as well. As a demonstration of our commitment to work with Canadians to solve problems that result in optimized outcomes, for the past three years we have been working with an indigenous-led health policy group to develop an indigenous health policy framework.