Take the U.K., for example, with NICE, which is their national purchasing agent. They're a unitary country, but they have the advantage that they're essentially bulk purchasing and negotiating with big pharma for the drugs that people are using.
We're very fragmented in the way in which we deal with this. Provinces try to do that, but arguably not nearly as successfully as would be the case if, for example, we had a national drug purchasing system, which many people have recommended.