All of the drugs that have been reviewed by the common drug review were approved by Health Canada as being safe and effective, upon their reading of the scientific and clinical evidence. Because the Patented Medicine Prices Review Board is responsible for ensuring that Canadians don't pay more than they should for their medications, the median price of seven countries is selected as the maximum price point for a company to sell that drug in Canada. They then send all of that information to the common drug review.
Because of the lack of transparency and openness at the common drug review, we don't know what else they're looking at. That's where we lose the trail, because they won't tell us. Then CDR makes their recommendation and their application goes to the provinces. You're absolutely right, that's where provinces look at their budgets and say, “Can we afford this medication? Can we afford to provide it to our citizens in our province?” At that stage a decision is taken that we can or can't afford it.
Our concern is, what's the added value of the common drug review? What is the added value they're bringing to the table, when we can't see what they're bringing to the table? That's why we'd love a review to tell us there's good stuff happening there, and there's a reason why they're making their decisions. We would be supportive if we knew what the reasons were, but we just don't know. That's the lack of transparency and accountability.
We do know that if a decision is made that's contrary to our clinical practice guidelines—our review of the evidence—we have no avenue of appeal. We can't say we don't understand why they made this decision. Only the company can appeal a decision, and it goes right back to the very same individuals who made the original decision. So how can you have confidence in this system? It has flaws.
So if you could review it and let us know that it's working effectively and there should be more transparency, we would go back to supporting it, because we think it is the foundation for a national catastrophic drug plan.
That's where we're at. Does that answer the question?