Mr. Shaun Flanagan:

We acknowledge that it is a very difficult and challenging area. My team enters every commercial negotiation in the hope of being able to get something over the line. We could improve the processes. The challenge around transparency is underestimated because it is impossible to understand the decision making unless one knows the pricing. The problem is the lack of transparency in pricing in the industry. It is impossible to give a coherent explanation of how a negative decision is made. My experience is that people who have significant challenges with the process often go away when the decision is "Yes". The key challenge is for the State to get access to as many medicines as it can. That is what will solve this issue. Even the fabulous Scottish patient and clinician engagement, PACE, system is experiencing a significant ongoing problem in regard to not having funded Orkambi. Members may think there is silence around that, but there is not.