Government officials scrambled in February to suppress proof of an incriminating intervention by Health Minister Jean-Yves Duclos into the independent agency that regulates drug prices, new documents reveal.
Duclos sent a letter last November that was “indistinguishable” from the pharmaceutical lobby’s talking points, triggering the suspension of a reform that would have saved Canadians billions in drug costs and a cascade of resignations at the regulator.
But the letter, which sparked a parliamentary probe after The Breach exposed it earlier this year, may never have seen the light of day if Health Canada officials had been successful in their attempts to pressure officials at the regulator and prevent the document from being released through an access to information request.
Although the Patented Medicines Prices Review Board (PMPRB) operates at arms-length from Health Canada, the documents show health ministry officials reached across departmental lines to express repeated “concern” about Duclos’ letter being released.
Among the officials who wrote the series of increasingly demanding emails is a former pharmaceutical lobbyist who now heads up a branch of the health ministry that advises the minister on drug policies.
Their emails are part of a large cache of government documents turned over to a parliamentary committee investigating the minister’s intervention with the drug price regulator, after his office was extensively lobbied by the pharmaceutical industry.
Health officials pressed regulator not to release letter
After the Liberals promised in 2017 to substantially lower drug costs in Canada, which are among the highest in the world, the pharmaceutical industry launched court challenges, threats to withhold drugs, and a lobbying blitz—successfully blocking all but one of the reforms.
In the final days of 2022, before the last remaining reform was to go into effect, industry lobbyists met with Duclos’ staff. Duclos then sent a letter to the drug pricing agency asking for another delay.
Although Duclos has denied any interference, the new documents make it clear that health ministry officials did not want his letter being released to the public.
“Have you released your package back to the requester, including the [Duclos] letter,” wrote a senior Health Canada official to an official at the regulator who deals with access-to-information (ATIP) requests. “If so, when? Or when do you plan to? Did your office consult with the Minister’s office?”
The documents show the drug regulator consulted with its lawyer and reminded Health Canada officials that it is an independent agency, and that questions about access-to-information releases should be handled by the two departments’ ATIP officials.
But health officials did not let up on the pressure, as the leader of their ATIP office stepped in with more questions.
That official stressed their “concern” repeatedly and requested a phone conversation, noting that the regulator indicated “no concerns” about disclosing Duclos’ letter.
Access to information disclosures are supposed to be free from political interference.
“It’s raising questions about undue influence by the health ministry to try to suppress information about this letter,” said Dean Beeby, a former Canadian Press bureau chief and expert on the government’s access to information process. “It’s smoke and maybe there’s fire there.”
Belated disclosure of the letter ‘certainly ironic’
Unknown to Health Canada officials was that at the time their emails were sent, Duclos’ letter had already been disclosed to The Breach under an access to information request in early February, almost two weeks before the officials started pressuring the PMPRB.
After Duclos’ letter was reported on by The Breach, followed by widespread coverage in other outlets, it was quietly posted on the Health Canada website.
Duclos tried to frame that as an intentional act of transparency, telling the parliamentary health committee that “in the interests of transparency, this letter has also been made public.”
Douglas Clark, the executive director of the drug pricing regulator who announced his resignation in February, emailed a colleague saying “it’s certainly ironic to be trumpeting its existence now when Health officials were having a cow a couple of weeks about its potential release under ATIP.”
The ATIP interference is the latest in a series of challenges to the independence of the drug price agency over policy reforms that have upset the pharmaceutical industry.
In his resignation letter, board member Matthew Herder stated that Duclos had “undermined the Board’s credibility and interfered with the exercise of a function that goes to the very heart of its expertise as an independent, arms-length administrative tribunal.”’
Herder stated that Duclos’ letter to the regulator was “largely indistinguishable in form and substance from industry talking points on the proposed guidelines.”
During the parliamentary hearings in early May, Herder called out the federal government for succumbing to pressure from the pharmaceutical industry.
“I want to raise a fundamental question about political courage in the face of industry’s power,” he said in his opening statement. “I urge the members of this committee, Parliament and Canadians more broadly to remain focused on industry’s power to control the policy conversation.”