Health committee  Thank you. I'll answer very quickly so we can hear about dealing with innovation successfully. The short story is, the stuff you need to go through regulation is different from the stuff that people who pay care about. So if you're doing regulation, you could do placebos, you could have super-healthy young patients.

Health committee  I apologize if what we've said has been complicated. From my perspective it seems very simple. We have people who are making things, we have people who are getting what's made, and we have a third group of people who have to pay for what's getting made. You can focus on how we get more things that we don't have money to buy.

Health committee  Could I ask for the question again, and how much time do we have?

Health committee  Could you take a long time asking the question again?

Health committee  I think CADTH does a good job communicating. The challenge is that with devices, the payer or customer is often the hospital. So even if CADTH gives its recommendation and even if Ontario gives its recommendation, if hospitals have the resources they will set up their own HTA units.

Health committee  I think that's a very smart way to go about using cost-effectiveness analysis: find things that aren't helping people and that we pay a lot for, and try to do less of them. One of the challenges in health care is that after you say yes and start paying for it, it is very difficult to bring that back in.

Health committee  All I wanted to say was that if the drug needs you to be positive on the test, and the ministry funds the drug only for the people who are positive, someone needs to figure out how we're going to get the test paid for, which labs we're going to contract with, how we'll know for sure that they have it.

Health committee  I'll give you an example. Let's say there's a new drug that works with people who have a certain set of genetic material, and you need a test to see if they have the right genes for the drug to work.

Health committee  Wouldn't I have done what?

Health committee  I'd like to be polite to my basic science colleagues. Could you speak about whether it's all planned out in the lab?

Health committee  That's a very good question. My perspective as a health economist is that I help people see how much extra they're going to have to pay and what they're going to get, so I describe this as positive analysis. It's seeing, basically in Consumer Reports style, that if we have a new drug, how much longer the patient is going to live with it and how much more it will cost.

Health committee  As I mentioned, I work at the pharmacoeconomics research unit. My job is to create cost-effectiveness analysis of new cancer drugs or to critique cost-effectiveness analysis of cancer drugs. I then explain it to a recommendation committee and say, for example, “We're getting two more months of life with this new cancer drug.

Health committee  It's a wonderful question. To be particular and exact, I feel I almost never make any recommendations. I try very hard to leave out my opinions. What bothers me a lot is when people don't understand what we are presenting as information. I've tried very hard to focus; instead of being complicated, I try to be clear in answering the question that the payer wants to know about.

Health committee  It rhymes with Scotch.

Health committee  I'm sorry, I was a bit nervous. I wanted to sort of link the notion that HTA was the ability to evaluate what you were getting. For example, if I were going shopping for a car, and I'm not a professor of automobiles, I would need help evaluating what I'm getting and how much it costs, so I would go to Consumer Reports.