Personally, I've lost confidence in the PMPRB's ability to make accurate international price comparisons.
And of course it's also related to the discounts and rebates that manufacturers offer to different clients, which are confidential. These types of discounts exist in Canada, but also in other countries.
As for transparency, I know that this was addressed in the first part of today's meeting. Transparency does exist at the global level, by which I mean that we can have access to some types of aggregated data. I revealed how this worked for Quebec, when I presented the numbers that you've just quoted. Innovative pharmaceutical companies gave a rebate worth more than $1 billion to the government of Quebec over the past four years.
This should be taken into account, at least when providing an overview of pharmaceutical spending trends. At the moment, the situation is being depicted as out of control, when this is not the case. To begin with, the population is aging and needs more medicines. Inflation also needs to be taken into account, which the PMPRB does not do. We also need to factor in the discounts I mentioned, and our ability to pay, which is based on our economy and the wealth generated. When all these factors are combined, it becomes clear that spending on drugs in Canada's economy and health budget has been decreasing over time. So there's no need to panic.