I do want to speak to the special access program that was brought up. I think this is a huge problem for us here. Quite frankly, as Dr. Stewart said, we had 13,000 requests and only 48 rejections. Really? Should we have a system in which we have 13,000 requests through SAP? Is this the way to run access? I don't think so.
We need to consider how we can bring many more of those drugs into the approval process. I think the pathway that Health Canada has put forth, the modernization of the regulations, could in fact encourage that, but I can tell you—and this is not the time to tell you—in great detail why the companies hesitate and why, even after they now apply, there are such barriers in terms of the approval and reimbursement process that a company looks up and says, "I don't think so." That's a problem. I think this is a challenge for us.
Definitely, as my final comment, we would like to propose a national pharmacare program in which the federal government actually can take a huge role. It was promised to us initially in 2006 when the Liberal government was in place. We actually had a proposal put in front of us from the federal-provincial-territorial committee around a program for expenses for rare diseases. In 2012, 2014 and 2015 we've had continual promises that this would be happening. We've yet to see anything materialize, even though we advocate on their doorstep at almost every health minister's meeting.
This is something we would like to see as part of this national pharmacare that's coming forth. We've had great discussions with Dr. Hoskins, and they have encouraged it. We need to have a program that is going to be publicly owned. It could have a private component to it if they choose to, but patients should have the opportunity to sign up for a public program funded by federal and provincial governments that's going to be one program, one set of guidelines, one approval process, one set of databases in which we can enrol patients and provide drugs in a managed fashion that would allow patients to get access to drugs as they are brought in.
If we have a parallel process with HTA and Health Canada, great. At the time of NOC we should be able to open up this program. The federal government, we believe, needs to take a huge role in doing that and we can bring the SAP into it. There's no reason that SAP drugs should not be adjudicated as part and parcel of that. You have a clinical panel. You have experts. You have databases. We can actually manage an entire rare disease program, and it will put us at number one. It will be something. Nobody has an ideal program. We think Canada is in a good position to actually step up to that spot.