Health committee  Let me start, and Mr. Ferdinand will jump in. That concerns me a great deal. My belief is that they are building in a cost-containment strategy that allows them to make decisions about cost versus patient outcomes. I have the darndest time, and I think you would too. How do you look a patient in the eye and say that something approved in the rest of the world, something available in those countries you mentioned, something approved by Health Canada, is not acceptable to CDR?

Health committee  On your question on the national pharmaceutical strategy, again, it sounds good, but I think it's going to give another false hope, just like CDR did. If we want to move toward making sure all Canadians are covered and have a catastrophic drug program, I think we have to build in something.

Health committee  Thank you for your three questions. I will attempt to answer them, and Mr. Ferdinand would like to add further comments. On the first point about the message about freezing funding, you're absolutely right that the federal government does not control the overall funding. But I think it would send a very clear message that we need to have this independent review.

Health committee  And it's not just the CDR: in more and more decisions, a barrier is being erected between doctor and patient. I think that Mr. Ferdinand has raised an important point because it seems quite clear in the case of new drugs, which are the ones we are talking about here. If the list is longer, you won't use it all, but there will be more choice.

Health committee  Thank you for your question. I think that the Quebec model answers your question for the most past. Because Quebec does not use the CDR, there are a larger number of drugs listed in Quebec. Up to 62% of drugs are listed and are thus accessible and available to Quebec men and women.

Health committee  I will begin to reply to your question, and Mark will complete my answer. I think that Quebec has understood that the proper use of innovative drugs and better access to them is a good health intervention because in this way one can improve the health of the population, save money and reduce the number of hospitalizations.

Health committee  As to your question, again it sounds interesting and quite positive when you throw out a simple idea: wouldn't it be nice if we...? But in reality, our greatest concern is that we would be moving to the lowest common denominator. As to your earlier point, I find it difficult to imagine how you're going to create a national formulary, possibly driven by a strategy very oriented to cost containment and that at a certain level will be making decisions about which drugs are available for which patients.

Health committee  To your question, and I stand to be corrected, my understanding is that the general answer is most. Part of it is the reason I highlighted. One of my concerns is not just the rejections, but how long it takes after a positive recommendation. It ranges, in some cases, to several hundred days, so one would presume that there is something happening during all that time, and again, it's another review.

Health committee  If there are any corrections from the other panellists—

Health committee  To your question, most politicians, certainly, if they're paying the piper, as you say, like to make the decision. Again, we talk about a good idea that sounds good on paper, but ultimately, who makes the best decision? Who runs it and who pays? In many cases, it is the provincial government.

Health committee  I'm not sure we can call it even a federal one. One of the issues is it seems to fall in between every level of government and the whole notion of appeal, transparency, accountability, and where the buck stops. I wouldn't quite call it a federal level; actually it's a creation of the FPT process.

Health committee  Thank you very much, Madam Chair. Good afternoon, everyone. I am pleased to be here on behalf of Canada's Research-Based Pharmaceutical Companies (Rx&D;). The Standing Committee on Health plays a vital role in ensuring that wherever the federal government invests money to improve the health of Canadians, it is done in an effective, transparent and accountable manner.