Thank you very much. I'm honoured to be able to present to this committee, and I thank you for inviting us.
l was employed by the federal government between 1974 and 1989, and l was the chief policy analyst on the 1987 Patent Act amendments. Those created the Patented Medicine Prices Review Board and curtailed the use of compulsory licensing. l was acting director at the Patented Medicine Prices Review Board between 1987 and mid-1989, when I left to create a private company, Brogan Incorporated. The idea was to bridge the gap between government and the private sector. I saw when I was in government that there was not a lot of communication of much substance. So we've tried to create an empirical base on which both parties could communicate on equal grounds.
It was not planned at that time, but we now have the largest prescription database in the country. We have somewhere around 1.5 billion prescriptions in our database, coming from a very large number of sources. We have140 dedicated professionals analysing and reporting on these data. These data obviously permit very extensive and complete analysis on a large range of issues, and they do so without jeopardizing patient privacy, since we don't have a patient ID. There's a scrambled code put in place of any direct patient identifier. These are the kinds of data that Dr. Dal Pan was talking about...owned by the private sector in the U.S.
Over this period of time, we've pioneered the analysis of administrative drug data, including beating the Americans to the punch, which I'm proud to say. We've already done many of the current and proposed new proposals that you heard about from previous witnesses. These analyses have been used by government, academia, and industry to inform decisions about drug coverage and utilization. We've conducted a number of studies measuring drug cost by age groups, regional variations, and a detailed analysis of high-cost claimants. By the way, some of that is provided in a briefing document I provided earlier.
Recently we completed an analysis of the Alberta seniors drug plan, a project we worked on in conjunction with the Alberta Ministry of Health. Another study looked at drug use by 1.2 million Canadian children. This is the largest study on pediatrics ever done anywhere from an administrative database. You've probably heard about NPDUIS. That's a simple re-creation of what we have already created. It's been under way at an exorbitant cost. The government could have bought something right off the shelf.
l think the committee will see there is a direct relevance to our activities and the questions it quite astutely has put forward for examination. Specifically, l would like to speak to just a few points: capacity for monitoring; surveillance and research; public access to information; and adverse reaction reporting.
We've developed a significant database and expertise in handling these complicated and large data sets. There is no risk to patient privacy. However, the government does not make adequate use of this capacity for monitoring, for surveillance, or for research. I think too much effort is put into replicating what already exists.
While the knowledge derived from our existing database is powerful and can be used for the better management of health systems, we're hampered by limited access to data. While we have the largest prescription database, we don't have data from every provincial government. Some government officials have been resistant to making these kinds of data available, and there's no clear reason for their position. This means valuable information for the management and improvement of the health care system is not being used.
I will give you a specific example to explain. We've discussed a data-sharing arrangement with all the cancer agencies in the country, and the participants are very interested in creating a central repository. However, it's not an unwillingness but a lot of effort is required for them to extract the data to send to us. While we have one province on board now, and we're looking for several others, it's a very slow and tedious project. This means that there is no comparative information on the use of cancer therapies across the country, little data on the effectiveness of treatments, and of course little data on adverse events rates in real life.
I don't want to dismiss the value of clinical trials; this is an add-on to clinical trial information.
The most powerful information will come from an integrated database where you're putting together all aspects of a patient's health resource use—again, without knowing who the patient is—and that would be lab tests, doctor visits, hospital visits, drug use. This is not difficult to do, but it is a very large project. Everything is there to have it done, but there has to be a willing spirit to make it happen.
We hope this committee would encourage Health Canada, for one, to make more use of the private sector in monitoring surveillance and research in all areas of health care. There is a capacity among private sector participants to dramatically expand what government agencies are trying to accomplish.
We would also suggest that this committee encourage governments that hold data to share this with the private sector. A more broadly based data set would allow us to extend our analysis significantly, and the more eyes examining the data, the more insights that will be developed. Of course, this will be done under the privacy and confidentiality rules that prevail now. I believe that all of this information can play a pivotal role in managing many aspects of the health care system.
Thank you, Madam Chairman.