Addressing fragmentation in Canada’s healthcare system
CMA prexy Dr. Alika Lafontaine discusses the privatization of healthcare delivery (1,475 words, 7 min.)
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Privatization of medical care is not a suitable tool for solving the many challenges facing the Canadian healthcare system, according to Canadian Medical Association (CMA) President Dr. Alika Lafontaine.
During a virtual talk on September 30, 2022, Dr. Lafontaine said fragmentation and siloing of resources and information are responsible for creating these challenges in Canadian healthcare.
Dr. Lafontaine, the first Indigenous president of the CMA, spoke at a virtual event organized by the Canadian Health Coalition, marking the National Day of Truth and Reconciliation. The discussion of privatization came up in response to an audience question regarding ways to address wait times and other resource challenges facing healthcare delivery in Canada.
“I don’t think private care is the answer. I think the approach of private care is part of the reason why we’re at where we’re at right now,” said Dr. Lafontaine. “The scariest part of private care for me is fragmentation. What have we learned from the fragmentation that’s happened not just across healthcare, but elsewhere?”
As one example, he referred to the Covid-19 pandemic and Canada’s lack of domestic vaccine production capacity. “We dismantled our ability to build drugs within Canada because we’re now outsourcing them to other countries, and we ran into major problems as a result of that [decision]. We were very, very lucky that we had partners that were willing to help us despite needing the resources for themselves.”
The current high rate of inflation arising from global supply chain issues shows that sourcing from all over the world “costs less until it doesn’t,” Dr. Lafontaine said.
He said a private hospital can be a good solution in some situations, citing the Shouldice Hospital in Markham, Ont., which specializes in hernia repair.
“They have a great system, where people get high-quality care,” Dr. Lafontaine said. “But that’s not most of medicine. You will never find a private institution incentivized to provide end-to-end care for something like a bowel resection for cancer. There are hundreds of people that need to touch that patient. Many, many specialties are involved. It will never be cost-effective for a company to create an end-to-end experience for that [condition].”
Canada has “potentially the most efficient health system in the world because everyone’s in the same pool,” said Dr. Lafontaine. “But we don’t lean into that seamless experience for people. We stay in our silos and don’t consider where it makes sense for us to work together.”
He noted that a trained physician who immigrates to Canada must contend with studying potentially 13 different provincial and territorial medical systems that all have varied requirements for licensing.
Hospital electronic medical record systems don’t communicate, so patients often have to undergo a duplicate round of scans and bloodwork. “There’s an enormous burden placed on patients to duplicate and repeat care. And there’s an enormous weight put on people within the system to do things that we know are redundant because our systems are not designed to be seamless.”
“The future of medicine and the solutions I think we need to look at are how can we create these collaborations across these silos? And in my opinion, and from the position of the CMA, the best group equipped to do that is the public system.
“The private market will never be incentivized to figure out this big problem. That is the big question: whether or not privatization will solve our problems. And I don’t think it will.”
THIS WEEK 10/04/22
The U.S. FDA has approved Santen Inc.’s omidenepag isopropyl ophthalmic solution (Omlonti) to reduce elevated intraocular pressure (IOP) in patients with primary open-angle glaucoma or ocular hypertension.
Sheri Dodd has been appointed President of Medtronic Canada, leading the Canadian commercial operations for the medical device company. Dodd succeeds Neil D. Fraser, who announced his retirement in July after 38 years.
AbbVie announced the availability of the XEN 63 Gel Implant, a surgical implant designed to lower high eye pressure in open-angle glaucoma patients, where previous medical treatments have failed.
Celltrion announced that the U.S. FDA approved bevacizumab-adcd (Vegzelma), a biosimilar to bevacizumab (Avastin), for the treatment of six types of cancer: metastatic colorectal cancer; recurrent or metastatic non-squamous non-small cell lung cancer (nsNSCLC); recurrent glioblastoma; metastatic renal cell carcinoma; persistent, recurrent, or metastatic cervical cancer; and epithelial ovarian, fallopian tube, or primary peritoneal cancer.
Pieter Cullis, Co-Founder of Acuitas Therapeutics, is the recipient of the 2022 Bloom Burton Award. The Bloom Burton Award honours an individual scientist, inventor, executive, entrepreneur, industry leader, or policy maker who significantly contributed significantly to Canada’s healthcare industry in the previous year.
LISTEN NOW
In season seven of the NPC Podcast, Michael Stone, General Manager for Canada of Mallinckrodt Pharmaceuticals, talks about taking on a leadership role during the pandemic, attracting younger, tech-savvy talent and the relevance of an education degree in pharma. Hear him in conversation with podcast hosts Mitch Shannon, Jim Shea and Mark McElwain. Season eight of the NPC Podcast begins tomorrow (10/05) with a conversation with Perry McLean of GSK.
CANADIAN HEALTHCARE MARKETING HALL OF FAME
The Canadian Healthcare Marketing Hall of Fame awards were established in 2002 to honour healthcare marketers who have contributed to our vocation and inspire others.
More than 100 honourees have been selected during the past 18 years. In the selection committee’s view, they represent a cross-section of the qualities that make our business unique and fulfilling. NPC Healthbiz Weekly will acknowledge one past Hall of Fame Honoree each week.
2003 Inductee
Richard J. MacKay
Montreal
Editor’s note: Dick has been the Chairman of the Advisory Board of Valeo Pharma Inc. of Montreal since 2009.
“Little did I know when I started in pharmaceuticals what a lucky choice this would be,” says Dick MacKay, founding president of Stiefel Canada Inc., “and the harder I worked, the luckier I got.” Selling Bibles door-to-door helped MacKay through university. After graduation, his selling skills earned him his first job in the pharma industry as a medical representative with Parke-Davis. When ICN bought that company, he moved into management with Winley-Morris and was appointed executive vice-president. One of the companies they represented in Canada was Stiefel Laboratories.
“Thanks to my previous experience, when I started Stiefel [in 1976], I was fortunate enough to know just about every dermatologist in Canada by name, and I still do. I think service is key for a niche market company such as ours.”
One of MacKay’s most significant milestones occurred early in his career when he met Dr. Bill Pace of London, Ont, a physician now recognized as the father of benzoyl peroxide for his pioneering role in developing that acne treatment. “Stiefel supported Bill in his early clinical research, which enabled us to be the first to introduce the treatment as Benoxyl lotion to Canadian dermatologists. We listened to what the dermatologists were asking for.”
“Listening also prompted the introduction of topical tretinoin, which was a controversial acne treatment at the time, but it quickly rivalled the benzoyl peroxide line.” In addition to several innovative products, Stiefel has also made several key acquisitions, including the Lederle line of dermatologicals in 1995 and TransCanaDerm in 1996. The company recently bought the oral antibiotic Minocin, a brand name well known to dermatologists. A new acne product, Clindoxyl, which contains benzoyl peroxide and clindamycin, has also been introduced. “It is our most successful product to date,” he says.
There have been temptations to diversify, but MacKay agrees with the company philosophy, “Choose what you intend to do, and do it well.” The company is generous in partnering with dermatologists in support of various interests, particularly in education and research at local and national levels. MacKay spearheads the annual fundraising campaign on behalf of the Canadian Dermatology Foundation, which provides grants to dermatological researchers and works closely with the Canadian Dermatology Association. He is also a former board member and chair of PMAC, now Rx&D.
MacKay says Stiefel’s employees are as important as their customers. “They deserve a pleasant environment and the best tools available to help accomplish their goals. We have many long-term employees, so I think we are doing something right.”
“When I took that first pharma job. I had no idea that most of my career would be devoted to running a company dedicated to dermatology: It has been such an extraordinary journey: exciting, rewarding, and fulfilling. I have made many lasting friendships. I have worked hard, and I’ve been very lucky. And I’d like to say I’m not finished yet.”
Register now for the 16th Annual National Pharmaceutical Congress on Wednesday, November 2
As Canada’s most important stage for leaders in the pharmaceutical industry, the Congress is an opportunity to learn, reflect, and network with the industry’s most prominent thought leaders and visionaries.
Join us at the Mississauga Convention Centre on November 2 for five panels featuring reflections, ideas, and innovations from luminaries in the Life Sciences industry:
The Future of Rare Disease & Oncology
Omni-Channel Marketing
Updated Perspectives for the New Normal
Evolving Roles in Commercial & Medical
Pharma’s New Role in the LifeSci Ecosystem
Register at phamacongress.info
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