The bottom line is that the provinces are paying both for the benefits and the consequences of not doing such a great job at evaluating things. They either do the foot-dragging approach of gee, this is pretty expensive and I don't really know, and I can't control it, and whatever else.... It's preciously important to actually get real-time information on who the drug is being used on and what the experience has been. Quite frankly, we have the capacity, if we keep it at a steady state—and, ideally, grow it a little bit—to actually answer these questions.
For example, one of the most notable studies that looked at how well a drug worked in practice in fact discovered that inhaled corticosteroids actually reduced the risk of asthma death, or near asthma death. That study was done by a group of researchers from McGill—not to be proud of my university or anything, but that group was from McGill—who used Saskatchewan data to try to address a problem that had been identified in Australia. Because we have such unique data here, we could actually answer that question.
It turns out that with one of the drugs that was producing a 55-fold death increase, a fast-acting rescue medication, the problem was essentially that it was very potent. What they discovered serendipitously through this was essentially a drug that is incredibly protective, just as we discovered that Aspirin is incredibly or wonderfully protective as time goes on.
It's these lessons learned that are going to come from ongoing pharmaco-surveillance of medications. It's expensive; we spend a lot of money on it, and increasing amounts of money on it, so we should do it right and actually monitor it, just as surgeons are monitored.