Health committee  No, I don't have all of those, but I certainly could provide you with a link to the website.

Health committee  They work very closely as well with patient groups and consumer groups to ensure that the information is spread widely as well.

Health committee  Yes, I'd love to speak to this as well. There's a new field within the type of work we do, and it's being referred to globally as disinvestment in health technologies. That's exactly what he was speaking to here. There are so many things we do in the health care system that were introduced without a good evidentiary platform for them.

Health committee  If I may, in speaking to that first question, and probably a little to the second question, Dr. Beaudet mentioned earlier about personalized medicine and the work they're doing with Genome Canada. A great innovation is that they've started to recognize that it's not just about producing the new technology; it's about having somebody actually wanting to use it and pay for it.

Health committee  I would echo a lot of those comments as well. One of our priorities is in mental health. We do a fair bit of work and review not just of drugs but of newer types of therapy, such as psychological therapies and other social therapies that are helping to both prevent and treat mental health illnesses.

Health committee  It's certainly something we look at when we're doing an assessment of a new technology or an existing technology, just to ensure that those human factors he talked about are actually going to make that technology useful to the system. You have hit on a significant issue, which is scopes of practice and who can use these newer technologies and advances.

Health committee  Madam Chair, there are probably two things I'd like to say about that. One would be related to the common drug review again. When it was established, every province and the federal programs that deliver health care had their own systems in place. Over the 10 years or so that the common drug review has been in place, there have been some independent analyses that have actually shown that we've reduced that duplication and we've actually allowed quicker access to some of these innovative technologies.

Health committee  It's probably a better question for our colleagues from Quebec. They have their own agency, Institut national d'excellence en services sociaux. It does very similar work to what we do. We do have a memorandum of understanding in place with that organization as well, so we do some collaborative work.

Health committee  All provinces still have their own decision-making. We're not the decision-making body. We provide the recommendations to them, but we have taken away the need for them to have this major review done.

Health committee  Perhaps I could speak to the second question regarding accessibility and the cross-border issues in Canada. Our common drug review, for example, was a program that was set up by the provinces and territories and the drug programs within the federal government. They created it about 10 years ago because of that issue.

Health committee  It's very different on the technology side. Drugs are so much easier because it's very top-down in most provinces. They have a drug plan and people in the ministry who do have controls in place. Devices are very bottom-up. New devices and new technologies are introduced into the system when, say, a manufacturer provides something to a surgeon or to a nurse and it slowly and easily becomes diffuse within the system without having a lot of information or assessment done of that technology.

Health committee  We'll work very closely with the clerk and see what we can produce.

Health committee  Thank you, Madam Chair, and thank you for inviting me to appear before the committee. Let me begin by telling you a bit about the Canadian Agency for Drugs and Technologies in Health, or CADTH. We are an independent, not-for-profit corporation that was established in 1989. We refer to ourselves as a health technology assessment organization, meaning that we provide evidence-based assessments of the clinical and cost effectiveness of pharmaceuticals, of diagnostics, and of medical, dental, and surgical devices and procedures.

Health committee  It would be very challenging for Health Canada to introduce that type of policy, which is very locally based, to determine the critical drugs that we require in our specific hospital and our specific situation. For many of the decisions it is very important to have the patient-physician interaction.

Health committee  I think that's an extremely important concept. Sole-sourcing is probably one of the key factors associated with the Sandoz shortage, whether it was the provinces themselves or the group purchasing among all of the hospital groups across the country that led to it. I will refer to one of the countries that we put in our report, New Zealand.