Thank you for the question.
I think some of the principles that the Auditor General of Canada mentioned in terms of what we should look at when we look at formulary management are principles that we try to adhere to. It needs rigour. Evidence is changing all the time. It needs to rely on expert advice. This is why we are looking at the common drug review process, and the expert group that supports that is giving us the first input about what we should do when a new drug comes on the market, or when new theoretical value is identified for a drug and we need to take that into consideration. I think the rigour in formulary management is essential.
Alignment with other plans is also very important, so that you don't get into a situation where patients going to see a physician receive a certain type of prescription from one physician, and because another kind is covered by someone else, they will receive a different kind of prescription. In fact, it's really difficult for the prescriber to know what is covered in one plan and in the others, so a certain alignment is good.
I think we have made progress. When I say we, it's not necessarily Health Canada only. I think, generally speaking, in Canada we have made progress in the last few years in some alignment that makes it easier for the prescriber, for the pharmacists who deliver, and for the client, of course, to access what they need. There is more progress that can be done. I would think rigour in this is important.
There are also specialized drugs that emerge. Cancer therapy that used to be delivered in hospitals now is often dispensed at the pharmacy desk, and people leave with this for home. These are new areas where we have to refine our process all the time because it's not static. The pharmaceutical offer is changing all the time. We need to have the capacity to adapt to these new realities and changes in the health system because the patients are also facing that. Therefore, the plans always need to be evolving.