The private plans will make any kind of second-generation innovative therapy available more quickly. The limitations come from the way in which the health technology assessments review the drugs for rare diseases. Like with Fabry's, they use a traditional method, and I think, as many of the other speakers have said, the level of certainty in terms of data is not there. They need a lot more post-marketing. They're going to be more niched even within that patient population. Not every drug works for everybody, so you have small patient populations.
What we have been able to do—and the private plans need to catch up with what the public plans are doing—is create the criteria for access. Similar to what everybody else has spoken about, and as Robyn indicated, within the rare disease access, no drug gets administered without good post-market monitoring. In fact, many of them are administered only through specialized clinics and very named physicians. It is not the case that anybody could write a prescription for a rare disease drug. In some respects, as I think Robyn said as well, we don't utilize all the resources that are available to monitor and track them. As Professor Herder was talking about, the limitations are definitely there, but it's not because we don't have the mechanisms. We do, but we don't employ them. I think those are where the challenges are. In some respects the public drug plans are providing appropriate access, but they're just slow about it. In many cases it takes a long time for them to set up the mechanisms.