First of all, Dr. Bennett, I understand that the patient-based care is different from population-based care, and that is something that we have to be clear on. The decisions made around reimbursement must be population-based, not individual patient-based, as you know.
But the first point that occurs in CDR is clinical effectiveness. That is the first barrier, the first gate that a drug must pass before entering into the cost-effectiveness phase, if you like. At the cost-effectiveness phase, the CDR is asked to comment on cost-effectiveness. And as Mr. Wright has said, it is up to the provinces to decide either with a yes on affordability within that province, or on a no, that actually they can't afford it. But this comes back to sustainability.
The most recent statistics from CIHI, the Canadian Institute for Health Information, indicate that health care costs went up by between 55% and 60% between 1999 and 2006. But drug costs, in the same period of time, went up by 110%, so the percentage increase of drug costs over health care costs doubled.
I'm not making a judgment call on those numbers, but they're reality numbers that the provinces have to deal with. And yes, there may be savings elsewhere in the system from certain drugs, and we understand that, and so do the decision-makers, but in looking at the sustainability of the system, these are all matters that must be considered.
However, getting back to the common drug review, our job is to look first at patient outcomes. And with respect to the drug that you're referencing, it was the patient outcomes that were in question.