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MPs want secrecy lifted from drug review process 

[PoliticsWatch updated 5:45 p.m. June 25, 2007]

OTTAWA  — Canada's Common Drug Review (CDR) is coming under fire from politicians in all parties who are calling for more transparency. 

The CDR is operated by the 13 provincial-territorial deputy health ministers and the federal deputy minister of health that established it. It provides formulary listing recommendations to provincial and territorial governments on which drugs should be publicly covered under provincial drug plans.  

A House of Commons committee spent the spring studying the CDR.

Doctors, patient groups and drug companies that appeared before the committee had a long list of complaints about the process. 

MPs who spoke to PoliticsWatch agreed that there was a need for greater transparency. The committee is expected to recommend to Parliament greater transparency on which drugs get approved or rejected for provincial drug plan coverage. The committee will table its report  when the House returns in the fall. 

Liberal MP Carolyn Bennett told PoliticsWatch that the "main problem" to come out of the hearings was that the CDR is not transparent like similar bodies in other countries. 

"I think the big black box where decisions are made is bothering people," she said. "The lack of an appeal process means that once it's been at the Common Drug Review, there's no way for either drug companies or citizens to try to persuade them to change their minds again."

"I think that we know that people want to know how decisions are taken."

NDP health critic Penny Priddy also said there is a need for greater transparency, especially when drugs are rejected. 

"People don't know why their drug is being turned down," she said in an interview with PoliticsWatch.

"If you're a patient who has been waiting for this drug that you know is out there and can make a difference in the life of someone in your family and it gets turned down, you want to know why." 

Priddy noted that while she believes the CDR is working in most areas, it's "not working" when it comes to approving expensive drugs for rare diseases. 

When officials representing the CDR appeared before the committee in June, MPs from all parties grilled them on the transparency issue. 

"I have to say, in fairness, a lot of the push-back that we've heard from a lot of different stakeholders is that CDR is not transparent," Tory MP Steven Fletcher told the officials, adding he believed it was "a fair criticism."

John Wright, co-chair of the Conference of Deputy Ministers of Health, earlier told MPs that he did not see "legitimacy to the issues that have been brought to my attention" about the CDR. 

However, he said while the CDR would be supportive of any effort to be more transparent, greater transparency should be a two-way street with drug companies. Officials told the committee they want drug companies to make their justification for drug prices and their submissions to Health Canada and the CDR public.

"We also suggest that the financial relationships between pharmaceutical companies, the disease-oriented groups they support, and those who develop clinical practice guidelines should be fully disclosed," Wright added. 

Mike Tierney, vice president of the CDR, told MPs that efforts are already being made to be more transparent when it comes to the approval process and more in-depth reviews of committee considerations will be made available in the coming year. 

When asked by PoliticsWatch, Health Minister Tony Clement was reluctant to comment on any of the criticisms that the committee has heard over the past few months. 

"Different people have different opinions about the efficacy of the Common Drug Review," said Clement. "It's not my place to go over all of their complaints about it." 

"I'm welcoming of the committee looking into the advantages and disadvantages of the Common Drug Review. The fact of the matter is we've got to work with our provincial and territorial partners on that issue."

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