The committee’s study of pharmaceutical sovereignty has consistently returned to the theme that Canada’s dependence on foreign drug manufacturing is a strategic vulnerability. Witnesses across multiple meetings have described a system where most active pharmaceutical ingredients and finished drugs are imported, leading to chronic shortages that harm patients and strain the health care system. There has been broad agreement that domestic manufacturing capacity, particularly for critical medicines like sterile injectables, antimicrobials, and insulin, should be strengthened. However, witnesses have differed on the scope of that ambition: some, like Christine Donaldson of HealthPRO Canada, have argued for a targeted approach focused on a short list of essential medicines, while others, such as Jeff Watson of Apotex, have called for a broader “buy Canadian” policy that includes generic manufacturing as a priority sector. Stéphane Lévesque of the Groupement provincial de l'industrie du médicament cautioned that pharmaceutical sovereignty will never be absolute and requires better federal-provincial collaboration.

A recurring tension has been whether sovereignty should be defined narrowly as supply chain security or more broadly as domestic innovation and patient access. Stéphanie Michaud of BioCanRx and Michel Bouvier argued that Canada must also create its own novel therapies, noting that only a small fraction of clinical trials are based on domestic innovation and that federal research programs have been discontinued. In contrast, patient advocate Kim Steele emphasized that sovereignty must include timely access to innovative medicines, citing the delayed launch of Trikafta as an example of how policy uncertainty harms patients. The role of generic and biosimilar drugs was also debated: Jim Keon of the Canadian Generic Pharmaceutical Association argued that sovereignty must start with generics, which fill 80% of prescriptions, while Bettina Hamelin of Innovative Medicines Canada warned that U.S. pricing policies are already delaying new medicine launches in Canada.

The committee’s work on pharmaceutical sovereignty has been repeatedly interrupted by procedural debates and motions related to other topics, particularly the termination of the PrescribeIT program. Over several meetings, the committee heard from Canada Health Infoway, Telus Health, and Health Canada officials that the program achieved technical integration with 95% of pharmacies but failed to reach adoption targets, with under 5% of prescriptions processed through the system. Witnesses attributed low adoption to the lack of provincial mandates or incentives, workflow irritants for physicians, and the absence of a sustainable funding model. There was disagreement over whether the program should be characterized as a failure: Telus Health’s Mohamed El-Demerdash emphasized its technical success and 99.9% uptime, while Health Canada’s Jocelyne Voisin acknowledged it did not meet its opioid-reduction targets. The committee’s efforts to investigate the program further were complicated by disputes over document production and witness summons, with the chair ruling several motions out of order and the committee unable to return to scheduled testimony for extended periods.

The committee also heard from the Canadian Centre on Substance Use and Addiction and from witnesses on the toxic drug crisis. CCSA CEO Dr. Alexander Caudarella and board members emphasized that substance use responses must include prevention, harm reduction, treatment, recovery, and enforcement as part of a coordinated system, and that supervised consumption sites should be embedded in broader health and social systems. Dr. Martyn Judson, appearing as an individual, argued that safe supply programs prescribing short-acting opioids keep patients locked in addiction and fuel diversion, and that long-acting opioid agonist therapies are more effective. This disagreement reflects a broader divide among witnesses on the role of harm reduction versus treatment-focused approaches. The committee also received testimony on the closure of the CFIA laboratory in Longueuil, with officials stating that food safety would not be compromised and that testing capacity exists at other labs, though the Chief Public Health Officer had not been consulted on the decision.