That's quite easy, because for Alzheimer's disease right now, there are only two kinds of medicine. One kind, which we've had for 10 years, increases the brain levels of a transmitter called acetylcholine. It was approved in Quebec and Ontario within a year or two, but there was a lag time for the Maritimes by about five years and a lag time for B.C. by about seven years. Now it's across the country.
The second class of drug comes from Germany and Austria, and this medicine is reimbursed only in Quebec, despite evidence building up that not only does this single drug work on another brain transmitter but also the combination of the two classes of drugs, as we have for diabetes and hypertension and most diseases, has an additive benefit to patients.
So we're at a standstill, because the CDR, the central review process, which currently excludes Quebec, seems to have a tendency to refuse all novel compounds. For the specific needs of Alzheimer's patients, there is one compound that has been used in Europe for over 20 years, available in Canada for four years, but reimbursed only in one province.