Although I've never been in the room and I'm not part of the process, from an outsider's perspective and having done candid interviews with the people involved in processes in five of these countries, I would argue that Canada actually focuses on costs less than all countries, except for NICE in the U.K. Canada and the U.K. really stand alone in their nearly exclusive focus on relative effectiveness and then a secondary consideration of costs.
Although CDR is criticized for that, I think it's patently incorrect, because Canada is one of the exceptions to the extent that it focuses on science rather than economics.