It's a very good question. That goes back to Ms. Kadis's point: how interested are we in speed?
I would ask all the committee members to imagine themselves undergoing surgery where someone is taking out a tumour, or a uterus, and so on, and the surgeon is standing in the operating room and has people, bureaucrats, standing behind him and telling him, “Go faster, go faster, you need to do this procedure quicker and quicker.” Most people would say that's completely irrational. You want your surgeon to do a proper job. You want him to take his time and be careful.
Why would we expect a different standard when it comes to evaluating or reviewing the safety of drugs? We have the manufacturers and the industry-funded patient groups saying “Faster, faster.” So I try to ask, is there any legitimacy to the need for speed? My answer would be, show me the conditions in which we are being slow in approving drugs. Is it in the high cholesterol? Is it cancer treatments?
We already have a number of programs in Canada where people with rare diseases can get pre-market access to drugs under clinical trial conditions. There are already those ways to get speedy drugs if you're facing life-threatening conditions. I can tell you, if I were facing a rare, life-threatening condition, I would want faster access to those treatments too. But they're so rare and so beside the point.
Most drugs are not treating rare and life-threatening conditions; they're treating high cholesterol, high blood pressure, gastroesophageal reflux, and the pain of arthritis—long-term, chronic treatments on which we can afford to take the time to make sure those drugs are causing more benefit than harm.
I hope that answers your question.