Health committee  Yes, I share that concern. I don't think that's going to be the impact. I think companies can afford to bring their products to Canada. I don't think the Canadian price has to be the highest in the world for companies to make a profit in the Canadian market. I don't understand th

Health committee  It's important to understand no two regimes are alike internationally. The thing that's unique about Canada, as Dr. Levine alluded to, is we don't have the monopsony power that most other developed countries have when they include prescription drug coverage as part of their unive

Health committee  I don't know which four drugs you're talking about, but—

Health committee  A number of these drugs are already on the market in Canada. I don't know exactly why they claimed this. I can say that this analysis is based on data that's now outdated. The thresholds that will be applied under the new guidelines are no longer the thresholds used as the basis

Health committee  I don't have the information in front of me. It's hard for me to provide an unequivocal response to your point. I don't know whether Mr. Levine wants to add to my response.

Health committee  If it's a forward-looking statement, part of it is fair. It's not that we're necessarily looking to reduce prices in Canada; it's just that we're looking to have mechanisms in place that ensure that prices are not excessive in Canada on a go-forward basis. The impact of that woul

Health committee  Your question is quite substantial. It would be an excellent idea to ask representatives of CADTH and INESSS to appear before the committee. I don't know whether this is on your agenda, but they should be answering these questions.

Health committee  Several of the measures that you just listed are part of our plan for the future. We agree with a number of these suggestions. The issue is that we're currently involved in two court challenges where the industry is making these types of arguments.

Health committee  I understand. However, the industry is making the arguments in the midst of these court challenges. This puts me in a bit of a delicate position to comment.

Health committee  Oh boy, that's a complex question. I will let Dr. Levine chime in if he wants to supplement my answer. We hear a lot from advocates for patients for rare diseases' pharmacoeconomic value. This is a very esoteric topic, but it shouldn't have application in this space because ther

Health committee  Well, it's really not for me to pronounce myself on the wisdom of the timing of those regulatory amendments. As I explained, they are the responsibility of the Minister of Health. I know that the amendments were originally slated to come into force in July 2020 but were delayed

Health committee  It's not a cap.

Health committee  Gosh, no. It's not a cap. It just means that if you're making $12 million or less on a particular drug, you're not subject to the new and more onerous, let's say, price ceiling. It's a mechanism to provide insulation from the application of the new regime. The new regime is not g

Health committee  One thing I should point out, and I did get into this a little bit in my presentation, is that when the regulatory amendments were published, they contained a cost-benefit analysis that projected about $8.9 billion in savings as a result of these changes, in net present value. I

Health committee  We didn't try to parse it that finely. I know that there is a lot of concern out there in the patient community about the impact that these changes will have on drugs for rare diseases. One of the things that I didn't touch on in my presentation, because I didn't have time, is