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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| Ilke Akpinar, Erin Kirwin, Lisa Tjosvold, Dagmara Chojecki, Jeff Round
Many publicly funded health systems use a mix of privately and publicly operated providers of care to deliver elective surgical services. The aim of this systematic review was to assess the role of privately operated but publicly funded provision of surgical services for adult patients who had cataract or orthopedic surgery within publicly funded health systems in high-income countries.…
| Baruch Levi, Stefanie Tan, Husayn Marini, Sara Allin
Emergency and urgent care systems in high-income countries face major challenges related to overcrowding, long wait times, and rising demand. Internationally, and across Canada, healthcare systems have experimented with various policies to promote access to health services for unplanned acute conditions while reducing avoidable visits to hospital emergency departments (EDs). This…
| Don Husereau, John Sproule, Christopher Henshall
Combination therapy is the use of two or more therapies with the intention of improving patient health which are increasingly becoming more prevalent in the health system. Combination therapies can be produced by a single manufacturer but often the various components of the combination are produced by different companies which creates complexities in terms of pricing and reimbursement…
| Stefanie Tan, Julie Farmer, Monika Roerig, Sara Allin
Internationally and across Canada, governments have explored varied approaches to reforming the governance and financing of primary care with the aim of improving access, efficiency, effectiveness, and patient experiences in the health system. This rapid review prepared for the Institute of Health Economics by the North American Observatory on Health Systems and Policies presents…
| 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…
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…
| 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…
| 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…
Primary care services after hours in Alberta are limited, and, as a result, emergency departments have long wait times and overcrowding as they accommodate a greater number of low-acuity conditions. In recent decades, various urgent care models have been established to fill the gap between emergency and primary care, with the aim of providing unscheduled services for urgent but…
| 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.
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…
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…
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…
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.
| Dat Tran, Ilke Akpinar, Richard Fedorak, Egon Jonsson, John Mackey, Lawrence Richer, Philip Jacobs
Purpose: In pharmaceutical clinical trials, industrial sponsors pay for study drugs and related healthcare services. We conducted a study to determine industry’s economic contribution of these trials to the Alberta healthcare system. Authors and Affiliations: Dat T. Tran1,2; Ilke Akpinar2 ; Richard N. Fedorak3 ; Egon Jonsson2 ; John R. Mackey4 ; Lawrence Richer5 ; Philip…
This report provides a summary of the IHE Biosimilars Forum engagement exercise that took place on April 23, 2017 in Ottawa, Ontario. The intent of the forum was to identify: options to categorize and consider biosimilars; a process to engage stakeholders to identify place in therapy and further evidence development that may be required; and an approach to knowledge exchange that…
| Deborah Marshall, Egon Jonsson, Liam Martin, Diane Mosher, Karen V. MacDonald
This White Paper discusses the concept of developing a comprehensive rheumatoid arthritis registry in Alberta, and the important health, social, and economic gains such a resource would generate for Alberta.
| Don Husereau, Anthony Culyer, Peter Neumann, Philip Jacobs
Abstract: Canadian and US health systems have often been characterized as having vastly different approaches to the financing and delivery of healthcare, with Canada portrayed as more reliant on rationing based on costs. In this article, we examine the similarities and differences between the two countries, the evolution and current role of health economic evaluation, and…
| Don Husereau, Philip Jacobs, Braden Manns, Ties Hoomans, Deborah Marshall, Robyn Tamblyn
This discussion paper has been produced in response to a request from CIHR Institute of Health Services and Policy Research (CIHR IHSPR). The discussion paper will provide guidance to those tasked with conducting an economic evaluation of complex health system interventions. The guidance will be an elaboration of existing National guidelines for economic evaluation, and serve as…
| Lianne Barnieh, Braden Manns, Anthony Harris, Marja Blom, Cam Donaldson, Scott Klarenbach, Don Husereau, Diane Lorenzetti, Fiona Clement
BACKGROUND: The use of a restrictive formulary, with placement determined through a drug-reimbursement decision-making process, is one approach to managing drug expenditures.
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.
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 project is concerned with describing a comprehensive set of HTA products, not the methods used to produce them. The report describes various products produced by HTA agencies and provides a summary of the basic elements of these products, but an in-depth analysis of, or comparison between, the various products in terms of their methodology is beyond its scope. Information…
| Thanh Nguyen, Anderson Chuck, Arto Ohinmaa, Philip Jacobs
Background: The benefits of pharmaceutical innovations are widely diffused; they accrue to the healthcare providers, patients, employers, and manufacturers. We estimate the societal monetary benefits of simvastatin in Canada and its distribution among different beneficiaries overtime.
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Initiative #23. This report is intended as a discussion primer for two challenges increasingly faced by health technology assessment (HTA), health impact assessment (HIA), health needs assessment, parliamentary technology assessment (PTA), participatory technology assessment, policy makers in numerous areas, health care…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Initiative #18. This paper has two specific objectives: to describe some of the challenges of using research evidence to inform healthcare policy making; and to provide policy makers and researchers with a framework or tool that would identify and facilitate the use of research evidence and other information in healthcare…
Alberta Heritage Foundation for Medical Research (AHFMR) Information Paper #24. The objective of this paper is to present the current evidence on the efficacy/effectiveness and safety of celeoxib (Celebrex®) for the treatment of pain in patients with osteoarthritis (OA) and rheumatoid arthritis (RA). Information Specialist: Seana Collins NOTE: In 2006 the Alberta Heritage Foundation…