Expensive drugs for rare diseases are a unique creature. The provinces and the federal government are dealing with Fabry's disease, and that's the one that's been most public. We've come up with a made-in-Canada approach to dealing with this. In the next three to ten years we're going to see an awful lot more of what I'll simply call designer drugs, designed specifically for genetic diseases. Pompe disease is another example, and I could go on and on.
These are extremely expensive. They cost not $10,000, $20,000, or $50,000 per patient; they cost hundreds of thousands of dollars per patient per year, if not $1 million. As a consequence, all of the provinces have come together, including Quebec, to take a look at how best to approach this. As you so rightly point out, there just isn't enough evidence out there. Fabry's disease is a very good example. The drug for it hasn't been around a sufficiently long time.
We need to come up with some parameters around this that balance the interests of the taxpayers and the interests of the patients. That's why we have an awful lot of good work going on relevant to the national pharmaceutical strategy. In fact there's a subcommittee to look at this and how we should approach it.
That's the best answer I can give right at the moment. I'm certainly very open to recommendations and would love to consider recommendations on expensive drugs for rare diseases. But that doesn't really relate at this moment to the CDR itself. This is something the provinces are considering just slightly outside of the CDR process, because of the very unique qualities and nature of it.