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 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…
This brief outlines some perspectives from the Institute of Health Economics (IHE) based on what we have heard from government, public agencies, and industry, and seeks to summarize the key areas where further clarification and deliberation could be helpful.
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…
Abstract: The cost of drug development is commonly cited between US$800 and US$1.8 billion. A similar statistic for vaccines is yet to be estimated, and it is unclear whether the cost of vaccines is similar to drug development. Financial and regulatory policy significantly impacts the extent and cost of pharmaceutical development, and as such it is important that…
| Thanh Nguyen, Anderson Chuck, Arto Ohinmaa, Philip Jacobs
Objectives: To estimate the monetary benefits of ramipril and its distribution over time among four beneficiaries in Canada: the drug developing manufacturer, generic manufacturers, the healthcare sector and employment sectors.
| Christa Harstall, Paul Taenzer, Nancy Zuck, Donna Angus, Carmen Moga, Ann Scott
Rationale, Aims, and Objectives: The Alberta Ambassador Program (AAP) adapted seven clinical practice guidelines on low back pain (LBP) into a single guideline spanning the continuum of care from prevention and diagnosis through to treatment. The Ambassador adaptation process was evaluated to 1 Identify the major challenges encountered and successful strategies utilized;…
INTRODUCTION: Varicella vaccine was introduced to the infant immunization schedule in each province or territory between 2000 and 2007 as a result of the Canadian ImmunizationStrategy. The impact of vaccinating children against this disease is potentially far reaching, asimmunization may also benefit those segments of the population not immunized. The objective of this paper…
This report is an analysis of the theoretical basis for value-based pricing, relevant international developments, and areas for improvement within Canada’s current patented drug pricing system. This report intends to inform future policy research, advice, and Canadian drug policy discussions regarding the feasibility and implementation of value-based pricing approaches.
This consensus statement on Legal Issues of Fetal Alcohol Spectrum Disorder (FASD) is the product of a unique IHE Consensus Development Conference held in September 2013. The event was a three-day juried hearing of evidence and scientific findings that allowed for the engagement and collaboration of citizens and decision makers in government and the justice system in addressing…
| Angus Thompson, Philip Jacobs, Jessica Moffatt, Arianna Waye
This service and evaluation project originated from the Alberta courts via the collaboration of two Alberta Ministries; (1) Alberta Justice & Soliciter General and (2) Alberta Environment and Sustainable Resource Development. The impetus arose when a judge in an environmental protection case observed a need for additional attention to the mental health of workers. An Alberta…
| Thanh Nguyen, Jessica Moffatt, Philip Jacobs, Anderson Chuck, Egon Jonsson
Objectives: To estimate the break-even effectiveness of the Alberta Fetal Alcohol Spectrum Disorder (FASD) Service Networks in reducing occurrences of secondary disabilities associated with FASD.
Abstract: Medical wait time is a top health policy issue in Canada. Reliable data on the referral wait time from primary to specialty care are limited. Existing data on referral wait times are generally self-reported by specialists. In 2008, the Edmonton North Primary Care Network (PCN) developed a Centralized Referral Program, including a specialist database that contains…
The Provincial Industry Payer Agreements in an Era of National Purchasing Strategies half-day invitational roundtable was part of the IHE's ongoing Methodology Forum series supported by the Institute of Health Economics, the Alberta government, and industry partners, AstraZeneca, Merck, and Eli Lilly. The event brought together academic experts, industry leaders and senior decision…
The Provincial Industry Payer Agreements in an Era of National Purchasing Strategies half-day invitational roundtable was part of the IHE's ongoing Methodology Forum series supported by the Institute of Health Economics, the Alberta government, and industry partners, AstraZeneca, Merck, and Eli Lilly. The event brought together academic experts, industry leaders and senior decision…
This health technology assessment report has been produced in response to a request from Alberta Health (AH) as part of the Alberta Health Technologies Decision Process (AHTDP) to perform an evaluation of the scientific evidence on the safety and effectiveness of TMJ Concepts® and Biomet® Microfixation TMJ prostheses for adults who are indicated for total TMJ replacement.…
Transcutaneous Bilirubinometry for the Screening of Hyperbilirubinemia in Neonates ≥35 Weeks’ Gestation This report was prepared for Alberta Health Services (AHS) and focuses on the published evidence about the safety, test accuracy, and clinical impact of the use of transcutaneous bilirubin (TcB) test for the screening of significant hyperbilirubinemia in term or late…
The review summarizes the current evidence on the safety, efficacy, effectiveness, and potential cost-effectiveness on the use of the BridgePoint Medical System (consisting of the CrossBoss™ catheter, Stingray™ catheter, and Stingray™ guidewire) for the recanalization of refractory coronary chronic total occlusions (CTOs). The report also describes the relevant…
| Thanh Nguyen, Egon Jonsson, Jessica Moffatt, Liz Dennett
From the Introduction: In this paper, we report a discussion of available evidence regarding the association between poverty and FASD, and regarding the economic consequences of FASD on individuals and families which may materialize an FASD - poverty trap.
The Institute of Health Economics, in partnership with Alberta Enterprise and Advanced Education, Alberta Health, and Eli Lilly Canada, conducted a roundtable to examine the concept of Alberta Health as a Living Laboratory. The ‘Living Laboratory’ concept builds off the recognition of the unique assets and opportunity we have in Alberta, including a single health authority…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an update of the 2008 report on islet transplantation (IT) for Type 1 diabetes (T1DM). Section One of this analysis was intended to describe the profile of T1DM (definition, progression, epidemiology, and population dynamics of affected adults in Alberta, in Canada,…
| Ian Colman, Yasmin Garad, Yiye Zeng, Kiyuri Naicker, Murray Weeks, Scott Patten, Peter Jones, Angus Thompson, T. Cameron Wild
Purpose: Studies suggest that childhood trauma is linked to both depression and heavy drinking in adulthood, and may create a lifelong vulnerability to stress. Few studies have explored the effects of stress sensitization on the development of depression or heavy drinking among those who have experienced traumatic childhood events. This study aimed to determine the effect…
Rationale, aims and objectives: The Appraisal of Guidelines Research and Evaluation (AGREE) instrument is a generic tool for assessing guideline quality. This feasibility study aimed to reduce the ambiguity and subjectivity associated with AGREE item scoring, and to augment the tool's capacity to differentiate between good- and poor-quality guidelines. Note: This is an Alberta…
The Consensus Statement on Fetal Alcohol Spectrum Disorder (FASD) - Across the Lifespan was produced by a panel of experts led by the Hon. Anne McLellan, former Deputy Prime Minister of Canada. This consensus statement on fetal alcohol spectrum disorder is the product of a unique conference: The IHE Consensus Development Conference on Fetal Alcohol Spectrum Disorder - Across the…
Le présent énoncé consensuel a été préparé par un panel indépendant de professionnels de la santé et de représentants du milieu universitaire et du public en se fondant sur: les études publiées pertinentes réunies par le Comité scientifique de la conférence pour l’établissement…
The Alberta Diabetes Surveillance System (ADSS) was created in 2006 in a partnership between Alberta Health and Wellness (AHW) and the Institute of Health Economics (IHE). The purpose of the ADSS is to provide information about diabetes within the province of Alberta. This information includes the incidence, prevalence and use of health care services for people with diabetes, along…
Written by health policy experts, the book gives a comprehensive overview of 8 different national health care systems and focuses in particular on the different approaches to maintain efficiency and to contain overall healthcare costs. Each chapter identifies the 4-5 specific policies with the highest impact for the respective country over the past 20-30 years and the current policy…
The objective of this report is to assess research evidence on the safety and prognostic value of exercise testing (including electrocardiogram exercise testing and cardiopulmonary exercise testing) for the prediction of cardiac events in patients with chronic diseases including diabetes, chronic obstructive pulmonary disease (COPD), and arthritis. Information Specialist: Trish…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is about testing for Human Papillomavirus (HPV). HPV is one of the most common sexually transmitted infections and can also cause cervical cancer. Cervical screening aims to reduce cervical cancer incidence and mortality by detecting precancerous lesions early. Until…
Les estimations indiquent que un canadien sur trois aura un problème de santé mentale durant sa vie. Peu de canadiens réalisent l’impact que la mauvaise santé mentale a sur les familles, les communautés, les systèmes de santé et l’économie. La santé mentale est aussi importante que la santé physique…
| Charles Yan, JoAnn Kingston-Riechers, Anderson Chuck
This report provides information regarding the impact of physician reimbursement models on five dimensions specified in the Provincial Alternate Relationship Plan Program Evaluation. The impact of physician reimbursement models were assessed on the following five dimensions: Health service utilization Access to care Quality of services Patient satisfaction Physician satisfaction…
The use of the term “comparative effectiveness” (CE) has attracted considerable attention, particularly in the United States. This booklet examines the concept of CE and its relationship to other assessment frameworks.
Background: Although many programs targeting fetal alcohol spectrum disorder (FASD) are implemented, the province of Alberta is still lacking information on costs of FASD.
Objectives: To estimate the costs of FASD in Alberta based on available US and Canadian research on costs of FASD, and Alberta data.
| Lisa Bergerman, Paula Corabian, Christa Harstall
The purpose of this report is to advance the area of workplace mental health through a comprehensive synthesis of published research evidence. More specifically, this report examines the evidence on the effectiveness of organizational-level interventions for the prevention of stress in the workplace for adult employees without diagnosed mental illness. The main effectiveness outcomes…
This report on assisted reproductive technologies (ARTs) is a literature review and secondary analyses of administrative health data conducted to provide information on the direct health care costs associated with multiple pregnancies and the potential cost impact of ARTs in Alberta. It examines the impact of multiple pregnancies and Assistive Reproductive Technologies on health…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #1. This report has been prepared to provide information and assist discussion on the management of pressure sores, a significant source of morbidity in health care institutions. The focus of the report is on a specific technology, interface pressure measurement. It is expected that other issues in this are will…