The outcome of IHE initiatives is providing better information for developing health policy and best medical practices. IHE disseminates information in many ways. In addition to publications in peer-reviewed journals, IHE produces books and a variety of reports synthesizing information in a particular field.
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| Dat Tran, Ilke Akpinar, Irvin Mayers, Tatiana Makhinova, Philip Jacobs
The objective of this study, published in the International Journal of Chronic Obstructive Pulmonary Disease, was to describe the trends in pharmacologic treatment for patients newly diagnosed with chronic obstructive pulmonary disease (COPD) in Alberta, Canada.
| Charles Yan, Katherine Rittenbach, Sepideh Souri, Peter H. Silverstone
This analysis, published in BMC Psychiatry, aimed to determine cost-effectiveness of a stepped-care pathway for depression in adults in primary care versus standard care (SC), treatment-as-usual (TAU), and online cognitive behavioural therapy (CBT).
| Samuel N. Frempong, Andrew J. Sutton, Clare Davenport, Pelham Barton
The aim of this study, published in PharmacoEconomics – Open, was to conduct an early economic analysis of a hypothetical rapid test for typhoid fever diagnosis in Ghana and identify the necessary characteristics of the test for it to be cost effective in Ghana.
This study, published in PharmacoEconomics – Open, reports exploratory analysis of the provincial and nationwide costs of industry-sponsored drug clinical trials (CTs) in Canada. The costs of industry-sponsored drug CTs completed in 2016 were Can$2.1 billion. In addition to the creation of knowledge, these trials play an important role in alleviating the healthcare cost burden…
| Dat Tran, Thanh Nguyen, Arto Ohinmaa, Irvin Mayers, Philip Jacobs
OBJECTIVES: To examine the resource use and healthcare costs for chronic obstructive pulmonary disease (COPD) in Alberta, Canada between 2008 and 2016 and model the future costs to 2030.
Clinical research is funded by industry, governments, charities, and hospitals. It is important to know the economic commitment of the various funding bodies, but until now there has been no national source available which provides these data. We surveyed the major funders to provide such a measure. There is evidence that government and charity funding of medical research is a…
| Helena M Earl, Louise Hiller, Anne-Laure Vallier, Shrushma Loi, Karen McAdam, Luke Hughes-Davies, Adrian N Harnett, Mei-Lin Ah-See, Richard Simcock, Daniel Rea, Sanjay Raj, Pamela Woodings, Mark Harries, Donna Howe, Kerry Raynes, Helen B Higgins, Maggie Wilcox, Chris Plummer, Janine Mansi, Ioannis Gounaris, Betania Mahler–Araujo, Elena Provenzano, Anita Chhabra, Jean E Abraham, Carlos Caldas, Peter S Hall, Christopher McCabe, Claire Hulme, David Miles, Andrew M Wardley, David A Cameron
Adjuvant trastuzumab significantly improves outcomes for patients with HER2-positive early breast cancer. The standard treatment duration is 12 months but shorter treatment could provide similar efficacy while reducing toxicities and cost. We aimed to investigate whether 6-month adjuvant trastuzumab treatment is non-inferior to the standard 12-month treatment regarding disease-free…
| Michelle Pollock, Ann Scott, Jennifer Seida, Paula Corabian, Andrew J. Sutton, Mike Paulden, Christopher McCabe, Lisa Tjosvold, Bing Guo
The clinical review and economic evaluation aimed to determine how Oncotype DX and Prosigna can be optimally used to determine which patients with early-stage breast cancer will benefit from adjuvant chemotherapy. This report addresses the following research question: For patients with early-stage (I–III), ER+, HER2?, node-negative or node-positive (one to three nodes) breast…
| Timothy Caulfield, Alessandro R Marcon, Blake Murdoch, Jasmine Brown, Sarah Tinker Perrault, Jonathan Jarry, Jeremy Snyder, Samantha J Anthony, Stephanie Brooks, Zubin Master, Christen Rachul, Ubaka Ogbogu, Joshua Greenberg, Amy Zarzeczny, Robyn Hyde-Lay
Abstract: Numerous social, economic and academic pressures can have a negative impact on representations of biomedical research. We review several of the forces playing an increasingly pernicious role in how health and science information is interpreted, shared and used, drawing discussions towards the role of narrative. In turn, we explore how aspects of narrative are used in…
| Dat Tran, Thanh Nguyen, Dawn Opgenorth, Xiaoming Wang, Danny Zuege, David A. Zygun, Henry T. Stelfox, Sean M. Bagshaw
This study, published in the Journal of Critical Care, explores the association between strained ICU capacity and healthcare costs, and demonstrates the admissions to ICUs experiencing strain incur incremental costs, attributed to longer hospitalization and physician services.
| Paula Corabian, Bing Guo, Carmen Moga, Ann Scott
This article retrospectively examines the evolution of rapid assessments (RAs) produced by the Health Technology Assessment (HTA) Program at the Institute of Health Economics over its 25-year relationship with a single requester, the Alberta Health Ministry (AHM).
| Paula Corabian, Bing Guo, Carmen Moga, Ann Scott
The Health Technology Assessment Program at the Institute of Health Economics has conducted rapid assessments (RAs) since 1993. This information paper draws on this experience and describes the evolution of RA process and products over a 25-year relationship with a single requester to quantify the effects of this partnership on the RAs produced. The aim is to contribute to emergent…
| Nancy Zuck, John Sproule, Charles Cook, Rebecca Albrecht
Alberta Health initiated the Nurse Practitioner Demonstration Project(s) (NPDP) in 2016 to support access to and further integration of Nurse Practitioners (NPs) into Alberta’s primary health care system. Funding was provided (based on diverse program plans) to the Boyle McCauley Health Centre (BMHC), The Alex Community Health Centre (The Alex), the Calgary Urban Project…
Ce rapport fournit un résumé d’un atelier de sprint sur la conception de données probantes du monde réel (DPMR) qui a eu lieu le 21 octobre 2018 à Toronto, en Ontario. L’atelier a été conçu et offert dans le cadre d’un partenariat entre l’Agence canadienne des médicaments et des technologies…
| John Paul Ekwaru, Arto Ohinmaa, Sarah Loehr, Solmaz Setayeshgar, Thanh Nguyen, Paul J Veugelers
Objective: Public health decision makers not only consider health benefits but also economic implications when articulating and issuing lifestyle recommendations. Whereas various estimates exist for the economic burden of physical inactivity, excess body weight and smoking, estimates of the economic burden associated with our diet are rare. In the present study, we estimated the…
This overview report provides a summary of the published information on the oxygen therapy issues studied in the past 10 years in the acute care settings. The report includes a summary of audit studies that aimed to address appropriate/inappropriate use of oxygen, and explores the safety and quality issues identified in the literature about oxygen prescription, administration,…
This report provides a summary of the IHE Biosimilars Forum engagement exercise that took place on October 6, 2016 in Edmonton. The intent of the forum was to inform Alberta biosimilar reimbursement policy by sharing international experiences in this area, and the perspectives of key stakeholders.
This rapid report provides a summary of current evidence on the application of gainsharing shared savings strategies in healthcare systems and the barriers and facilitators related to their implementation.
Economic evaluation helps policy makers and healthcare payers make decisions on drug listing, coverage, and reimbursement. When economic evaluations are conducted before a product launch, the prices of the pharmaceuticals have to be forecast.
The Institute of Health Economics (IHE), in partnership with the Canadian Pulmonary Fibrosis Foundation (CPFF), held a forum on April 25th, 2016 in Toronto, Ontario, entitled Optimizing access to care for patients with idiopathic pulmonary fibrosis: A multi-stakeholder national forum, to discuss the need for patient-led policy recommendations and a patient charter for idiopathic…
| Thanh Nguyen, Anderson Chuck, Tracy Wasylak, Jeannette Lawrence, Peter Faris, Olle Ljungqvist, Gregg Nelson, Leah Gramlich
BACKGROUND: In February 2013, Alberta Health Services established an Enhanced Recovery After Surgery (ERAS) implementation program for adopting the ERAS Society colorectal guidelines into 6 sites (initial phase) that perform more than 75% of all colorectal surgeries in the province. We conducted an economic evaluation of this initiative to not only determine its cost-effectiveness,…
This white paper follows on from the 2016 IHE report, Economic surveillance for chronic obstructive pulmonary disease (COPD) in Alberta. It provides a summary of main gaps in COPD care across Canada and, in the context of a broad economic framework, it surveys important examples of programs and policies designed to address these gaps.
| Arto Ohinmaa, Yufei Zheng, Thomas Jeerakathil, Scott Klarenbach, Unto Häkkinen, Thanh Nguyen, Dan Friesen, Jane Ruseski, Padma Kaul, Ruolz Ariste, Philip Jacobs
OBJECTIVES: This study aimed to evaluate the trends and regional variation of stroke hospital care in 30-day in-hospital mortality, hospital length of stay (LOS), and 1-year total hospitalization cost after implementation of the Alberta Provincial Stroke Strategy.
| Thanh Nguyen, Justin Ezekowitz, Dat Tran, Padma Kaul
BACKGROUND: Eplerenone has been demonstrated as being cost effective for the treatment of patients with systolic heart failure (HF) and mild symptoms in several jurisdictions; however, its cost effectiveness is unknown in the context of Alberta, Canada.
Objective: The objective of this paper is to estimate the additional mental health service costs incurred within the criminal justice system that are incurred because of people with mental illnesses who go through the system. Our focus is on costs in Alberta.
The Institute of Health Economics (IHE) together with the O’Brien Institute for Public Health (O’Brien Institute) held a policy forum on February 8th, 2016, entitled Physicians as Stewards of Resources: Roles, Responsibilities, and Remuneration to inform decision-making regarding the fiscal sustainability of theprovincial healthcare system, with a specific…
| Anderson Chuck, Thanh Nguyen, James Wesenberg, Rhada Chari, Robert Wilson, Selikke Janes-Kelley
Objectives: In 2006, the Alberta Ministry of Health issued a policy to implement fetal fibronectin (fFN) testing as a publicly funded service for pregnant women. The goals were to reduce maternity health care utilization and unnecessary treatment, which would result in cost-savings for the health system by more accurately diagnosing false preterm labour. We conducted a post-policy…
This guide has been developed by the information specialists at the Institute of Health Economics in Edmonton Alberta and is intended to facilitate searching for health technology assessments (HTAs) or systematic reviews by providing the list of current and reliable internet-based resources that we regularly use in our work. We have tried as much as possible to match this guide…
| Arianna Waye, Philip Jacobs, Maria Ospina, Michael Stickland, Irvin Mayers
This report provides the results of an economic surveillance analysis on the components of the Alberta healthcare system that are devoted to COPD prevention and treatment. It focuses on epidemiology (prevalence and incidence), service use, and cost indicators, and identifies gaps in the system that presumably add to the overall economic burden of COPD. PDF of the above image: IHE…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This STE report examines the safety, screening accuracy, therapeutic efficacy/effectiveness, cost-effectiveness, budget impact, and health system readiness of newborn screening for seven conditions (galactosemia, tyrosinemia type I, homocystinuria, sickle cell anemia, sickle…
Objectives: To estimate the life expectancy and specify the causes of death among people with fetal alcohol syndrome (FAS). Methods: Included were all patients recorded in Alberta provincial databases of inpatients, outpatients, or practitioner claims from 2003 to 2012. People with FAS were identified by ICD-9 code 760.71 and ICD-10 codes Q86.0 and P04.3, and were linked…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This rapid report has been produced in response to a request from Alberta Health to provide an update on the new published research evidence on the efficacy/effectiveness, efficiency, and safety of hysteroscopic tubal sterilization (HTS) using the Essure® system for permanent…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an update of the “Technological efficacy/effectiveness analysis” (T) section of the 2014 Alberta STE report, which was an evidence assessment of the clinical effectiveness and safety of endovenous ablation interventions for symptomatic varicose veins…
Abstract: Canada having a universal health insurance plan that provides hospital and physician benefits offers a natural experiment of whether continuity ofcare actually provides lower or higher utilization of services. The question we are evaluating is whether Canadians, who have a regular physician, use more health resources than those who do not have one? Using two statistical…
| Maureen Yunkap Kwankam, David Hailey, Philip Jacobs
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #13. This assessment has been prepared in view of the interest at the University of Alberta Hospital in developing a cord blood banking facility in the province and to provide information to decision makers on the current status of cord blood transplantation (CBT). The principal purpose of the assessment was to…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #12. This report has been prepared following a request from the provincial Clinical Practice Guidelines Program for information on the accuracy of diagnostic tests for the detection of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomoniasis in females of reproductive age. The intention of this…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #11. This report has been prepared in view of the increasing interest in ultrasound technology for diagnosis of osteoporosis. Until recently, quantitative ultrasound (QUS) was mainly being used in research settings. This procedure is still not covered by provincial fee schedules. The recent FDA pre-marketing approvals…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #10. This report has been prepared as part of a project to assess the role of high cost functional diagnostic imaging (FDI) and related methods in routine health care. In the present paper, the potential application of four FDI methods to the management of epilepsy is considered. The assessment considered the current…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #8. This report has been prepared to provide information to health authorities and others on the available evidence on effectiveness of HBOT and the possible economic impact on health care should a second HBO facility be established in the province. Issues addressed in the report include: Whether HBOT has been…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #9. The present report has been prepared following a request by Alberta Health in relation to referral of patients outside the province for treatment with stereotactic radiosurgery (SRS). There was interest by the department in the comparative effectiveness of the two main approaches to SRS (GK and LINAC) and in…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #7. This assessment was undertaken at the request of a Regional Health Authority to provide input into a funding decision on a computerized dynamic posturography (CDP) system for use by a rehabilitation department. The focus of this study was restricted to the clinical use of CDP by the rehabilitation community.…