Health technology assessment, which is what the Canadian Agency for Drugs and Technologies in Health—or its acronym, CADTH—engages in, assesses pharmaceuticals in a manner very similar to that of other agencies around the world, including New Zealand. I would say, in actual fact, that the Canadian approach is very precise and very meticulous, probably at a higher quality than I experienced when I was in New Zealand.
Canada has at its disposal, right at the heart of its decision-making, extremely good information on which to make decisions about what to put into a formulary and what the costs and benefits of those options are, etc. It has that ability and it has the technology, if you like—the institution in place—to make that happen.
What it has is a large number of different purchasers around the country that take advantage of that information and use it in different ways. As yet, it doesn't have the ability to fully utilize that information for the purposes of creating a national pharmacare program, and that's not the fault of the HTA body, the health technology assessment body. That's the fault, if you want to call it a fault, of the structures we have in place in order to achieve some form of national consistency in our access to pharmaceuticals, and indeed to achieve universal access. All of the abilities are there in Canada. It's just a matter, in my view, of structuring them in a way that enables Canada to take advantage of them.