There are delays at every step of the way. The first step is the regulatory approval by Health Canada, which regulates whether a new medicine is safe and effective. That process takes about a year.
There is in legislation what's called reliance, where Canada can rely on other regulators that are credible and are ahead of time. That is one step.
After that step, there is what's called a pharmacoeconomic analysis, which takes another six to eight months. After that, negotiations occur between the manufacturer and the pan-Canadian Pharmaceutical Alliance. It usually takes up to six months for a file to be picked up after Canada's Drug Agency has taken up the file. The provinces may not list the medicine, even when the pan-Canadian Pharmaceutical Alliance, which negotiates on their behalf, has arrived at a price with the manufacturer.
At every step of the way there are delays. It's a mix of red tape and capacity in the system.
It's definitely not a system that is globally competitive. In this time of trade negotiations and trade wars, this is not a good environment to operate in.