I think I used the word “tension”, and the word “tension” is the one I would still apply to the situation. There will always be a tension, because the mandate of private industry is to gather return on investment and profits. Our mandate is to perform scientific, rigorous work based on the data, and the data is often provided by the industry, but not in its entirety.
As I said earlier, the cost-effectiveness work is done following clinical effectiveness. Sometimes the data are insufficient, and sometimes we draw conclusions, as is clear in our recommendations, that are not satisfying to the industry.