Thank you all. This was all very useful information. I could not write fast enough to keep up with all that was really useful.
First, I have a couple of questions for Dr. Tamblyn.
We talked about an evidence-based formulary and about there often being alternatives that are more expensive but that don't do as well. We've had some criticism in the past, with some physicians and patients wanting choice even if the choice for a more expensive medication is not actually based on any improved outcomes.
Would you foresee a system wherein you could approve a drug for use, so that people had that choice, but not have it on the formulary? If someone has a proton pump inhibitor that is cheap, they can have it prescribed and it's paid for. If they really paid attention to the ad that said “Ask your doctor about Prevacid” and want that, they could get it, but they pay for it.
Is a system like that feasible?