I've heard of pharmaceutical companies—and I have dealt very directly with pharmaceutical companies—that have levelled that threat. We've been able to work with them very collaboratively to ensure that our patients maintain access.
Part of the problem that the pharmaceutical companies are now facing, as I understand it after speaking with a whole host of them and a lot of my patients being on clinical trial drugs, is that the expectation now—even when there's a reimbursement deal in place for whatever drug has been approved—is that those patients who were part of the clinical trial aren't included in that reimbursement deal. Governments are still expecting companies to foot the bill for them.
For instance, there is a reimbursement deal in place for a rare disease drug that will be announced, I assume, sooner rather than later. The small details are that 20% of the Canadian population participated in the clinical trial. The reimbursement deal is in place, but governments still want the company to foot the bill. If you have 20% of your revenue stream being given away to those patients, even after that deal is made and they've been paying for them for the course of the last six years, it's really difficult for them to then start inching up into the profitable margins.
It's not the companies that I work with and deal with, and understand I'm very selective in the companies I deal with. I make sure that I am connecting only with companies that are in line with my moral values. They don't want to be removing patients by any stretch of the imagination. However, it does happen.