Health committee  At DND, we also do generic substitution. However, what we've also done, prior to the partners, is enter into agreements with manufacturers, and contracts with manufacturers would sometimes give us a preferred price. Sometimes it may be better than the generic price. So there are

Health committee  If we switch to a generic product, no, not forced switching.

Health committee  Again, what we have is a therapeutic interchange. Where it's deemed to be interchangeable in two jurisdictions in Canada, then, yes, we would only pay for the generic.

Health committee  We also have jurisdictional issues across the country in that we are multi-jurisdictional across the various provinces and because our care can be provided after hours. Then there are also changes that you have to accommodate, because certain provinces may have certain drugs on t

Health committee  I can't comment on the individual provinces, but based on my attendance at CDR and the recommendations, each province has its own mandate and exercises it based on the recommendation. If one province feels it has the funding to pay for a drug that wasn't recommended based on cost

Health committee  I'm not saying that. CDR makes its recommendation, and the provinces can determine whether or not they can fund the drug, based on their mandates. So it's not a matter of whether the decision is CDR's or not. Each provincial mandate allows the province to determine if it can pay

Health committee  With respect to DND, the product that was alluded to by Mr. Potter is a regular benefit on our drug plan, and we do have that. That was the Evra patch.

Health committee  Again, based on our patient population, and I also alluded to it in my opening remarks with respect to our need to deploy, we have a limited list capability, which means that we can't take every single drug. We just don't have the capacity to move them. The other thing is that we

Health committee  From DND's perspective, yes, we do need the analyses. It is a recommendation and it is based on a pharmaco-economic analysis that takes an uptake of the drug in each jurisdiction. Because we have various jurisdictions with quite a varying population, that uptake may not be the sa

Health committee  No. We do need the recommendation, because the recommendation includes the pharmaco-economic analysis. What we need to do is individualize that for our program, bring it to our deputy minister or whoever, and let them make the decision on whether we will fund it.

Health committee  On behalf of DND, I can't comment on the exact number, because again it's a case-by-case basis, and at times you look at the economics between sending a person off to undergo a surgical procedure or putting them on a medication that may help them, and that's how you have to weigh

Health committee  In that regard, I think you have to address that through to CDR. They would be best to answer that question.

Health committee  As Ms. Bruce indicated, we have come together to have a core formulary, and based on our different needs, our patient population from 17 to 60, many disease states are not prevalent within our patient population and therefore we do not list those products for those disease states

Health committee  On behalf of DND, no, there were no drugs that were not approved that I would have liked to see on the....

Health committee  That's correct.