Certainly. The problem with pediatric formulations is exactly what you said: products are not formulated for children. I think the real problem in Canada has been that many of these products that are formulated for children—they may not be optimal, but they're improvements over the crushing—are available in many other markets in the world, but for different economic reasons, the brand companies have never introduced them in Canada.
One of the initiatives that we supported, at the request of the CHU Sainte-Justine, was to make some of these products available to Canadians. One of the things that we discovered was that Health Canada was treating many of these products—that were 20 years old and had approved indications in children—almost like they were new products, like they were products that it had never heard of. Second, they were assessing fees on them to bring them to market that were almost at the same cost as new chemical entities. We started this initiative to think about how could we make pediatric formulations and bring innovation to them. We started off with the lowest level of innovation by just introducing things that were available elsewhere and seeing how the market would accept them, and we found this huge barrier to getting even those products to market.
Where did Health Canada hurt us? Health Canada helped us by paying attention to us. Health Canada listened to the issues, but its regulations, as we were told, forced it to charge us fees that made the development of these products really uneconomical.
Second, Health Canada followed its rules about looking at health and safety, but it did not look, as many of us on the panel have said, at the foreign regulatory bodies that have looked at this. It has access to those communications, yet it insisted on things being redeveloped here, which became another burden.
The centre has done a pan-Canadian study of all of the children's hospitals across Canada. They are all suffering from the same issue of inaccessibility to products. The alternatives to compounded products are well known to be inferior and to have potential safety issues. There's a will, but the regulations do not permit the fast adoption of these products.