I will be honest. I think there are a lot of great things going on in terms of drug review and reimbursement.
Our greatest challenge is that we are still murky in some areas. I mentioned rare diseases and the drugs for rare diseases. It's partially about how these drugs are assessed and recommended for reimbursement through the health technology assessment, but it's also about having predictability of funding and being able to access those medicines.
One of the biggest challenges we face is that of the recommended price reductions that a body like Canada's Drug Agency might recommend for some of these innovative therapies. Some of these therapies can be assessed, and it's recommended that there be a 90% price reduction. It's very difficult to get innovative therapies through to reimbursement if that is the price recommendation.
If we look at the pCPA, we see that they've done some great initiatives in collaboration with the CDA. We are starting to see things move through the system. I would say that there's a lot of work being done to look at patient engagement at those levels, and we're starting to see some really positive change, to the point that we are writing submissions because there are so many consultations going on. We are able to sit back and look and say, “Wow, some good things are actually happening here in Canada at all levels.”
Our challenges were not cohesive. These are all different parts of a system that isn't necessarily a system. We break down not just at the health technology assessment bodies when it comes to some of these innovative therapies and how they are assessed. We also break down because we have programs in individual jurisdictions that may reassess. Those are non-binding recommendations, so the provinces and territories and the public drug plans in general don't necessarily have to take those recommendations. Sometimes that's a good thing. Sometimes that's a bad thing.