Health committee  I agree. You're never going to agree with all the decisions that are made, and there is certainly a wide variety of different values that people are going to bring to issues around pharmaceutical policy and what drugs should be covered and what drugs shouldn't. But I think the m

Health committee  The fact that the pharmaceutical industry is heavily concentrated in the Montreal area is well known. The rest of it is speculation, based on the fact that, as I said, the Quebec provincial government has made the development of the pharmaceutical industry one of its key pieces o

Health committee  I had a piece of cold pizza at a drug lunch 10 years ago.

Health committee  There are anecdotes from various places that suggest that drug companies sometimes try to use their economic power to influence decisions. For instance, back in 1971, when Manitoba set up its public drug plan and its formulary, the reaction from the pharmaceutical industry was th

Health committee  We used a set of criteria to decide which agencies to compare to. First of all, they had to use the same kind of evidence that the CDR uses, which is a combination of pharmaco-economic analysis and clinical evidence. They had to have evaluated at least half of the CDR drugs. Th

Health committee  I think it would be a good idea to compare quality of life in a different group of patients with the same disease in different provinces, where access to care is different, but those kinds of studies haven't been done. If CIHR wants to fund those, I'd be happy to put in an applic

Health committee  First of all, it's Dr. Lexchin.

Health committee  Second, I never said anything about whether or not there should be more or less clinical expertise on CDR. All I was doing was pointing out that the CDR decisions are broadly in line with decisions made by similar groups that use similar levels of evidence. I do agree that we n

Health committee  There is no easy answer, obviously, to your question, but certainly there are a number of factors that you need to consider. First of all, there is the difference in the financial ability of provinces. As long as your drug programs are province-based, you have to deal with the re

Health committee  We're not sharing risk, though, for all the rest of the drugs. If you look at public spending per capita on drugs, it's very closely related to provincial GDP per capita. The more money the provinces have, the more money they have to spend on drugs. So unless you're looking at

Health committee  Unfortunately, when I was coming up on the train with VIA, one of the train attendants spilled water on the computer. I now have a dead computer, at least for a couple of days. Once the computer is resuscitated, I'll be happy to send a version, but it probably won't be until next

Health committee  Thanks very much for the opportunity to appear here. My name is Joel Lexchin. I'm an MD. I teach health policy at York University, as you pointed out. I also work as an emergency physician, and I have authored a number of books prescribing guidelines for general practitioners a