I think CADTH does a good job communicating. The challenge is that with devices, the payer or customer is often the hospital. So even if CADTH gives its recommendation and even if Ontario gives its recommendation, if hospitals have the resources they will set up their own HTA units. There's one at McGill. There's one in London, Ontario. The decision is always local, but the problem is that we don't have the resources for everyone to set up their own HTA.
CADTH is necessary and people want to add their own context.