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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This report identifies extreme heat adaptation strategies that might be feasibly implemented before and during summer 2022, with a focus on vulnerable populations. Information for this report was collected through a rapid review of published and grey literature and summarizes the current evidence on strategy effectiveness and cost, as well as factors influencing implementation…
| Bruce Ritchie, Karen J. B. Martins, Dat Tran, Heather Blain, Lawrence Richer, Scott Klarenbach
Self-administered subcutaneous immunoglobulin G (SCIg) reduces nursing time and eliminates the need for treatment at ambulatory care clinics, as compared with clinic-based intravenously administered IgG (IVIg), and are therapeutically equivalent. Using administrative health data in Alberta, this population-based cohort study examined the costs of IgG administration (SCIg versus…
| Thomas Vilches, Ellen Rafferty, Chad Wells, Alison Galvani, Seyed Moghadas
Diagnostic testing has been pivotal in detecting SARS-CoV-2 infections and reducing transmission through the isolation of positive cases. This study quantified the value of implementing frequent, rapid antigen (RA) testing in the workplace to identify screening programs that are cost-effective. The findings provide important insights which can inform testing strategies. The modeling…
| Sara Allin, Sierra Campbell, Margaret Jamieson, Fiona Miller, Monika Roerig, John Sproule
The Institute of Health Economics contributed as part of the team authoring the Canada Report for the Partnership for Health Sustainability and Resilience (PHSSR) initiative. https://www.phssr.org/findings The report lead author was Dr. Sara Allin, the Director for the North American Observatory on Health Systems and Policies. https://www.dlsph.utoronto.ca/2022/11/15/strengthening-primary-care-key-to-rebuilding-canadas-crumbling-healthcare-system/…
| Charles Yan, Nathan McClure, Sean Dukelow, Balraj Mann, Jeff Round
Increasing demand for provision of care to stroke survivors creates challenges for health care planners. A key concern is the optimal alignment of health care resources between provision of acute care, rehabilitation, and among different segments of rehabilitation, including inpatient rehabilitation, early supported discharge (ESD), and outpatient rehabilitation (OPR). In this…
| Carmen Moga, Mohammad Karkhaneh, Dagmara Chojecki, Bing Guo, Erin Kirwin, Negar Razavilar, Jeff Round, Erica Wright, Charles Yan
Low back pain (LBP) is one of the most common forms of musculoskeletal pain in mid-age adults, with episodic and recurrent pain that can span over the entire life. LBP is a major public health problem worldwide because of its prevalence, associated temporary or permanent disability, and the extensive use of healthcare services by patients. This report aims to identify the appropriate/inappropriate…
| Don Husereau, John Sproule, Ron Vender, Charles Lynde, Jaggi Rao, Jennifer Beecker, Antonella Scali, Christian Boisvert-Huneault, Margaret Peters, Rachael Manion
Pustular psoriasis is a rare form of psoriasis and a chronic disease, with patients experiencing diminished quality of life, reduced productivity, stigma, and shortened life expectancy from disease. Optimal management of pustular psoriasis requires access to healthcare providers with highly specialized knowledge. The rarity of the condition means some patients may receive inappropriate…
This commentary clarifies and reinforces recommendations provided in a recently published article on the second edition of the practical guide for evidence-informed deliberative processes (EDPs): “Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide”. While the practical guide draws on an extensive amount of information…
| Carmel Montgomery, John Sproule, Jeff Round, Christopher McCabe
Using the example of frailty care in Canada, this discussion paper was completed in 2021 and presents an adaptation of the WHO Best Buys principles as a tool to support higher-level decision making and priority setting for high-value healthcare investment. Our goal is to support decision-makers to reduce the preventable and avoidable burden of morbidity, mortality and disability…
| Lindsey Warkentin, Carmen Moga, Lisa Tjosvold, Mohammad Karkhaneh, Bing Guo, Dat Tran, Negar Razavilar, Jeff Round
Since the development of the fiberoptic endoscope in the late 1950s, endoscopy has become an indispensable tool for gastroenterology. The demand for gastrointestinal endoscopy services in Canada has outstripped its availability, resulting in prolonged wait times, patient anxiety and reduced satisfaction, and potential adverse health effects. Capacity for more urgent indications…
| John Sproule, Ken Bond, Lindsey Warkentin, Bing Guo, Nancy Zuck
This report is the result of a national consultation and roundtable deliberations conducted by the Institute of Health Economics to support the development of a National Strategy for Heart Valve Disease in Canada. Two virtual policy engagements with clinical leaders, patients and health system managers were conducted in November 2021. These workshops identified 9 thematic areas…
| Erin Kirwin, Rachel Meacock, Jeff Round, Matt Sutton
The diagonal approach is a health system funding concept wherein vertical approaches targeting specific diseases are combined with horizontal approaches intended to strengthen health systems broadly. This paper aims to develop a theoretical framework for the diagonal approach. It allows concurrent evaluation of three different types of horizontal interventions, those: (i)…
| Samantha Pollard, Dierdre Weymann, Brandon Chan, Morgan Ehman, Sarah Wordsworth, James Buchanan, Timothy P. Hanna, Cheryl Ho, Howard J Lim, Paula Lorgelly, Adam Raymakers, Christopher McCabe, Dean Regier
This study defines a core data set to facilitate economic evaluations of precision oncology. Precision oncology is generating vast amounts of multiomic data to improve human health and accelerate research. Existing clinical study designs and attendant data are unable to provide comparative evidence for economic evaluations. This lack of evidence can cause inconsistent and inappropriate…
| Melanie McPhail, Christopher McCabe, Dean Regier, Tania Bubela
Regulatory and reimbursement decisions for drugs and vaccines are increasingly based on limited safety and efficacy evidence. In this environment, life-cycle approaches to evaluation are needed. A life-cycle approach grants market approval and/or positive reimbursement decisions based on an undertaking to conduct post-market clinical trials that address evidentiary uncertainties,…
| Erin Kirwin, Jeff Round, Ken Bond, Christopher McCabe
This paper presents a Life-Cycle Health Technology Assessment (HTA) framework designed to address three challenges faced by standard HTA: uncertainty, evolving evidence and health system sustainability. The LC-HTA framework is built around on-market evidence generation and risk-based pricing strategies. Where…
Long COVID has no commonly accepted case definition, but is characterized generally as the persistence of any COVID-19 symptoms past the typical convalescence period. Initial reports are emerging of significant ongoing symptom burden for some COVID-19 cases, but the prevalence and profile of these long-term cases, and the potential need for or utilization of community-based supports…
This report provides a summary of a real-world evidence (RWE) design sprint workshop that took place on October 21, 2018 in Toronto, Ontario. The workshop was developed and delivered as a joint partnership between the Canadian Agency for Drugs and Technologies in Health (CADTH); Canadian Association for Population Therapeutics (CAPT), Health Canada, and the Institute of Health…
| Dat Tran, Robert Welsh, Arto Ohinmaa, Thanh Nguyen, Padma Kaul
Little is known about the resource use and cost burden of acute myocardial infarction (AMI) beyond the index event. We examined resource use and care costs during the first and each subsequent year, among patients with incident AMI.
This environmental scan describes existing initiatives that aim to accelerate the diagnostic phase of cancer care in Alberta, Canada, and internationally. Specifically, it describes their development and implementation, structure and functioning, intended outcomes and effectiveness, costs and cost savings, and enablers and barriers.
| S.P. Bisch, T. Wells, L. Gramlich, P. Faris, X. Wang, Dat Tran, Thanh Nguyen, S. Glaze, P. Chu, P. Ghatage, J. Nation, V. Capstick, H. Steed, J. Sabourin, G. Nelson
The Institute of Health Economics has contributed to a study published in the Journal Gynecologic Oncology. The study described the effects of Enhanced Recovery After Surgery (ERAS) guideline implementation in gynecologic oncology on length of stay, patient outcomes, and economic impact in Alberta. The study compared pre-and post-guideline implementation outcomes at two centers…
This study originated from discussions on how to translate research findings into conclusions regarding safety and effectiveness in systematic reviews responding to requests from a provincial mechanism for introducing and diffusing publicly funded healthcare technologies. Its objective is to identify prominent and reliable evidence grading systems used in health technology assessment…
| Jasmine Brown, Roger Bland, Egon Jonsson, Andrew Greenshaw
Objective: Fetal alcohol spectrum disorder (FASD) is a medical term used to describe a range of mental and physical disabilities caused by maternal alcohol consumption. The role of alcohol as a teratogen and its effects on the cellular growth of the embryo and the fetus were not determined on scientific grounds until the late 1960s. However, the link between alcohol use during…
| Jasmine Brown, Roger Bland, Egon Jonsson, Andrew Greenshaw
Objective: Fetal Alcohol Spectrum Disorder (FASD) is a preventable disorder caused by maternal alcohol consumption and marked by a range of physical and mental disabilities. Although recognized by the scientific and medical community as a clinical disorder, no internationally standardized diagnostic tool yet exists for FASD. Methods and Results: This review seeks to analyse the…
| Charles Yan, Yufei Zheng, Michael D. Hill, Balraj Mann, Thomas Jeerakathil, Noreen Kamal, Shy Amlani, Anderson Chuck
Abstract: We present a conceptual approach to determine the optimal solution to delivering a health technology, consistent with the objective of maximizing patient outcomes subject to resources available to a publicly funded health system. The article addresses two key policy questions: 1) adding system values through appropriate planning of health services delivery and 2) considering…
As the Federal Government contemplates introducing an element of value-based pricing to the pharmaceutical industry regulatory framework, this report provides an overview of key theoretical and empirical material, to support informed engagement by all stakeholders in this important debate.
| Rodger Craig, Carmen Moga, Bing Guo, Dagmara Chojecki
The Institute of Health Economics (IHE) was commissioned by the Canadian Cardiovascular Society to provide a rapid update of the literature, to compare the impacts of public reporting and external benchmarking on selected outcomes, and to evaluate and describe the applicability of this body of research to non- competitive health systems, emphasizing perspectives and considerations…
Objective: The aim of this study was to analyze the health care costs and savings associated with quality improvement (QI) interventions initiated and implemented utilizing the National Surgical Quality Improvement Program (NSQIP). Background: Five acute care facilities of Alberta Health Services (AHS) adopted NSQIP in 2015 for a pilot project. Methods: The cost-savings of NSQIP…
This report provides a summary of the proceedings from the IHE roundtable on diabetes care and management in Indigenous populations in Canada, held on November 1, 2017. The roundtable aimed to: discuss and share learnings and promising practices from successful community-led diabetes programs, highlighting approaches to effectively engage communities to co-develop prevention and…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #34. This report reviews the literature on assessment of telecardiology, considering applications in pediatric care, hospital or clinic use for adults, emergency care, and home care. Information Specialist: Seana Collins NOTE: In 2006 the Alberta Heritage Foundation for Medical Research HTA unit moved to IHE. Documents…
| Robert Lee, Karie-Lynn Kelly, Chris Newcomb, David Cooke, Edidiong Ekaette, Peter Craighead, Peter Dunscombe
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Initiative #15. This paper summarizes the first steps in a research program designed to inform technology assessment and decision-making associated with radiotherapy (treatment of cancer with ionizing radiation) at the Tom Baker Cancer Centre (TBCC) in Calgary, Alberta. NOTE: In 2006 the Alberta Heritage Foundation for…
Alberta Heritage Foundation for Medical Research (AHFMR) Information Paper #21. The objective of this report is to evaluate the published evidence on the safety, efficacy, and current status of living donor liver transplantation for the treatment of end stage liver disease in children. Information Specialist: Leigh-Ann Topfer NOTE: In 2006 the Alberta Heritage Foundation for Medical…
Alberta Heritage Foundation for Medical Research (AHFMR) Information Paper #19. The objective of this report was to conduct a systematic review of the published research on the use of sclerotherapy to manage varicose veins of the legs. The intent of this paper was to answer the following questions: Is sclerotherapy effective for varicose veins of the legs and if so, is one approach…
| Leanne Kmet, Robert Lee, Linda Cook, Diane Lorenzetti, Glenys Godlovitch, Edna Einsiedel
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report. In this systematic review, we have critically reviewed the literature addressing the social, legal and ethical issues related to genetic testing for cancer susceptibility, synthesized current information and identified existing gaps in knowledge. We believe the review will prove valuable to policy- and decision-makers…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #33. This report is a systematic review and critical appraisal of the evidence on the use of ovulation induction (OI) drug therapy to manage anovulatory infertility associated with polycystic ovary syndrome (PCOS) in women of reproductive age. The aim was to provide the current published scientific evidence about…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Initiative #13. Appraising the quality of evidence is an important, yet difficult task, complicated by the consideration of disparate evidence. Quality checklists for assessing RCTs abound, yet it is acknowledged that even within this single study the reliability, validity, feasibility and utility of the various tools…