Thank you, Mr. Chair, and like my colleagues, I thank you for the invitation to appear before the committee.
I'm Brian O'Rourke, the president and chief executive officer of the Canadian Agency for Drugs and Technologies in Health, and that's the last time I'm going to use the full title because I'll run out of my 10 minutes. Plus, we prefer to be called by our acronym, which is CADTH.
Let me begin by telling you a little bit about CADTH, the work we do, and how that may be of value to your study on the development of a national pharmacare program.
CADTH is an independent not-for-profit corporation established in 1989, and the members—or as we call them, the owners—of CADTH are the federal, provincial, and territorial deputy ministers of health, who fund the agency. That's Health Canada and all provinces and territories, with the exception of Quebec. We're governed by a board of directors that reports to the deputy ministers. Our annual operating budget is approximately $28 million, with 58% of that coming from the federal government and 27% from the provinces and territories, all except Quebec again. As well, 15% of our revenue comes from other sources.
We refer to ourselves as a health technology assessment agency, meaning that we provide evidence-based assessments of the clinical and cost-effectiveness of drugs; diagnostics; medical, dental, and surgical devices; procedures; and programs.
In essence, we have two broad areas of work: our drug portfolio and our medical devices portfolio. We have a number of programs and products in place to support the management of medical devices in Canada. However, I'll focus my comments today on our drug portfolio.
CADTH provides a range of services to support the effective management of pharmaceuticals in Canada: most notably, the CADTH common drug review, well known by its acronym CDR; and the CADTH pan-Canadian oncology drug review, known as pCODR.
The CADTH common drug review program is a federal, provincial, and territorial process, established in 2004 to provide a common approach for reviewing the clinical and cost effectiveness of new drugs and existing drugs that may have new uses. We also receive input from patient groups as part of this review. It certainly is a wonderful example of federal, provincial, and territorial collaboration. The common drug review supports coverage decisions for 18 of the 19 publicly funded drug plans in Canada, including the six plans managed by the Government of Canada for specific populations that Ms. Hoffman mentioned, such as members of the military, veterans, and Canada's first nations and Inuit people.
The pan-Canadian oncology drug review program was established by the provinces and territories in 2010, again with the exception of Quebec, and was transferred to CADTH on April 1, 2014. The federal government joined as a funding partner of pCODR on April 1 of this year. Similar to CDR, pCODR provides a common process for the assessment of cancer drugs and makes reimbursement recommendations to Canada's federal, provincial, and territorial drug plans and cancer agencies to guide their cancer drug funding decisions.
CDR and pCODR programs support funding decisions for individual drugs. We also conduct multi-drug reviews on classes of drugs under the auspices of our therapeutic review and optimal use programs. For example, we've completed therapeutic reviews of biologics used to treat patients with rheumatoid arthritis; we've conducted a therapeutic review on the new drugs that are used to treat patients with hepatitis C; and we're currently undertaking a project to assess the clinical and cost effectiveness of new drugs for the treatment of patients with type 2 diabetes.
These therapeutic reviews and optimal use projects support formulary management decisions, and they provide the evidentiary foundation to promote the appropriate prescribing and utilization of prescription pharmaceuticals. However, we are challenged with keeping up with the demand for therapeutic reviews of prescription pharmaceuticals required to support the public drug plans. They're very valuable to the policy-makers and to the clinicians to help them navigate how new and typically very expensive drugs fit within the therapeutic options currently available. In addition, they help answer questions as to whether or not older drugs are being used in the most appropriate way, based on the evidence.
For example, we have done a number of projects looking at the evidence related to prescription drug abuse. These therapeutic reviews, however, are extremely complex to undertake, and they are very resource intensive. This is, indeed, one area of our pharmaceutical portfolio that could benefit from additional funding.
As another example, the cancer agencies have started to ask us if we could do therapeutic reviews on classes of cancer drugs. That would be extremely helpful for them. However, we're not currently resourced to conduct reviews in the cancer space.
One other service I'd like to mention is our rapid response service where we provide quick evidence reviews of the dauntingly large and complex medical literature. This service is extremely valuable in that it directly addresses urgent needs for evidence that informs both policy and practice.
Mr. Chair, CADTH has well-established linkages with government officials tasked with managing the federal, provincial, and territorial drug plans, and the cancer agencies. For example, we have several advisory committees and working groups with representation from all public drug plans. In fact, that's where I was this morning. We have a meeting of our drug policy advisory committee drug plan managers from across Canada here in Ottawa. And we provide secretariat support for a group that's referred to as the federal, provincial, and territorial pharmaceutical directors' forum.
We have developed partnerships with Health Canada and many other health organizations to promote collaborative work in the pharmaceutical space, and we have created mechanisms to engage patient groups, clinicians, and representatives from the pharmaceutical industry.
We also work closely with and support the work of the drug safety and effectiveness network, housed at the Canadian Institutes of Health Research, and we're open to exploring the transfer of DSEN, the drug safety and effectiveness network, to CADTH as was recommended in the Naylor report.
We also provide drug listing recommendations and additional health economic support to the pan-Canadian Pharmaceutical Alliance that was mentioned earlier, which is responsible for implementing the drug funding recommendations that we make in a consistent manner, and in working with manufacturers to help address concerns that we identified during our CADTH reviews.
Mr. Chair, CADTH's existing programs and services, our linkages to federal, provincial, and territorial drug plans, our partnerships with other health care organizations, and our willingness to interact with concerned stakeholders such as industry and patient groups, certainly could be leveraged to enhance the management of pharmaceuticals in Canada.
We are well positioned to contribute to a national formulary, as was described in the mandate letter of the health minister, and to enhance both the accessibility and affordability of pharmaceuticals for Canadians.
Mr. Chair, that concludes my remarks, and I'm open to answering any questions that may come up.