The conditional listing idea is Australian. Australia operates it, and they have a similar government structure to ours. So I think we could look at them in more detail and adapt it for the Canadian situation.
We think there are a lot of stakeholders at the table right now who aren't communicating through the common drug review process. A conditional listing would help get those drugs that have been approved as safe and effective by Health Canada, so it would still go through the safety review with Health Canada. It would be a drug that's also been given a price point by the Patented Medicine Prices Review Board.
At that stage, the company and the federal government—and if it were the common drug review, it would go to them to negotiate—would bring the company to the table, bring an organization like ours with the expertise that could help design a research program, work together, and identify the research program to identify the real-world health outcomes and the real-world costs. A lot of the cost estimates that are being made are based on clinical trials or other studies that aren't based on the real world or in the Canadian context. So we think there's a real gap here that needs to be addressed.
If we could do that, then government has ultimately the ability to ensure that the questions they want answered are asked. Industry knows they have a responsibility to pay for the research, but they also have an opportunity to have a contribution and input into the design of the research project. Organizations like ours can be assured that the expertise that needs to be there to ask those research questions is at the table. Right now, there's no ability for us to do any of that quality assurance.
We think the conditional listing is the way to go. It's also, I think, very similar to what Health Canada introduced back in February in its white paper on a progressive licensing model. Australia is the model we'd suggest you look at.
The other thing around national standards is that it really shouldn't matter where you live in Canada if you have diabetes, but it does. There are 17 diabetes medications that have been approved by Health Canada as safe and effective, and the Patented Medicine Prices Review Board has allowed them to be for sale. Right now if you have money you can go out and buy those drugs if your physician or doctor prescribes them, but if you're on a drug plan in Ontario, you have access to six of them; if you're in Atlantic Canada, it ranges. So every province has a different number. The national standard issue is very dear to our heart, and we want everybody to rise up.