I would agree with Neil. Last year, for example, 50 products were reviewed by the common drug review. Forty of them got a “list” or a “list with criteria or conditions” recommendation from the health technology assessment agency.
They determined that 10 of them were just not clinically valuable, and there was nothing you could really do on the economics to actually support a negotiation, but a full 40 of them got some kind of yellow light or green light to go forward on negotiations.
Last year, 2015, was a big year. The federal drug administrations in the U.S. and Canada actually approved or authorized more drugs than they had in the previous 12 years—45 drugs in the U.S and 43 in Canada.
A big volume of very interesting, and I think valuable, products are coming to market every year, and that's a testament to what they are coming out with at the common drug review, which says that they are clinically useful, and that something should be done about the price, or maybe that the clinical criteria should be changed. That isn't what Health Canada says it should be set up for, but the pCPA is now struggling with that volume of new products. Maybe there's a role for the Government of Canada in helping to facilitate that and improve how the pCPA works.