Health committee  Some of them have. Again, another aspect of the guidelines that I wasn't able to get into is the impact of that Federal Court decision that I mentioned. Going forward, until we have clarity from the Federal Court of Appeal and it reverses the decision at trial, the only price ceiling that these medications will be subject to is the median international price.

Health committee  No problem. Absolutely.

Health committee  Yes. The 2019 report will come out soon. It usually comes out in the fall in the last few years. I don't know the exact timing off the top of my head. I don't have the number at my fingertips either. I can certainly undertake to get back to you on that. In terms of the applications going down and the number of clinical trials going down, a lot of people have made that assertion, from industry predominantly.

Health committee  Okay.

Health committee  Okay. I'm going to go straight to the impact; I think that's what people are really interested in. There's a lot of conflicting information out there about what the impact of these changes will be, ultimately, on prices, revenues and savings in the Canadian system. There are three types of medicines, if you want to unpack the impact.

Health committee  Yes.

Health committee  I'm in your hands. It will take some time to go through this presentation. I had originally envisaged presenting it to you when we had two hours at our disposal. Now that it has been reduced to an hour, as I know committee members have an awful lot of questions, it might make more sense to just dive into them.

Health committee  Okay, sure.

Health committee  I'll just refer you to the PowerPoint presentation that was sent to committee over the weekend. I'm going to zip right through this. I know that the committee has passed a motion to review and study our guidelines, but it's important to understand and to situate these guidelines in context.

Health committee  There's a formula that's based on CPI. Provided they're compliant with that calculation, then yes, they can increase their price in keeping with CPI on an annual basis until they hit that wall, that absolute ceiling that is the highest international price. That doesn't happen in every case.

Health committee  Yes. That's the system.

Health committee  I agree with that.

Health committee  Well, as I mentioned, list prices are only half the battle, right? The real price is the price net of rebates, which—

Health committee  Well, that's been proposed, so that train has left the station. There is a regulatory process, and it takes time. I think it's complicated in this particular instance by the fact that we have other components to that regulatory proposal—namely, the new factors for the PMPRB to consider in determining what constitutes an excessive price.

Health committee  Ultimately, the Minister of Health makes it, but it is subject to ratification by cabinet, by Treasury Board, like any regulation.