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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| 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…
| Susan Armijo-Olivo, Bing Guo, Nathan McClure, Carmen Moga, Negar Razavilar, Jeff Round, Lisa Tjosvold, Dat Tran, Charles Yan
This health evidence review assesses strategies for the delivery of high-quality and cost-effective stroke rehabilitation care in Alberta to inform decisions about how the province might increase care capacity for stroke rehabilitation services and maximize the benefits of effective treatment interventions. The review assesses two novel approaches to the delivery of high-quality…
| 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).
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…
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.
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…
This report provides a summary of the IHE/CAPT Precision Health workshop that took place on October 22, 2017 in Toronto, Ontario. The intent of the workshop was to identify gaps and opportunities in implementing precision health technologies into the Canadian health system. The workshop was supported by unrestricted grants from Merck Canada and Hoffmann-La Roche Limited.The views…
| 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…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This STE report examines the social and system demographics, technological safety and therapeutic efficacy/effectiveness, cost-effectiveness, and budget impact of endovascular therapy for acute ischemic stroke, contextualized to the Alberta setting. Section Authors: Section…
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…
This report provides a summary of recently published information (January 2015 to present) regarding the glucose monitoring technologies that are commercially available in North America, as well as those that are emerging within the next five years (up to 2021).
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,…
PDF of a PowerPoint presentation by Mr. Murray Aitken, Senior VP and Executive Director, IMS Institute for Healthcare Informatics.
6 Oct 2016 – IHE Biosimilars Forum
| 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.
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…
| Werner J Becker, Ted Findlay, Carmen Moga, Ann Scott, Christa Harstall, Paul Taenzer
Objective: To increase the use of evidence-informed approaches to diagnosis, investigation, and treatment of headache for patients in primary care.
Note: This is an Alberta Ambassador Guideline Adaptation Program related publication.
| Victoria Ung, Thanh Nguyen, Karen Wong, Karen Kroeker, Thomas Lee, Haili Wang, Arto Ohinmaa, Philip Jacobs, Richard Fedorak
BACKGROUND & AIMS: Infliximab is effective for induction and maintenance of response in patients with moderate to moderately severe ulcerative colitis. Previous cost analyses of infliximab treatment for ulcerative colitis used models of colectomy vs infliximab and response rates derived from early clinical trials. In real life, therapeutic options are more complex; patients…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an evidence assessment of the clinical effectiveness and safety of hysteroscopic tubal sterilization, and the value for money associated with adopting hysteroscopic tubal sterilization in Alberta. Section Authors: Section One – Background and Context: Carmen…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an evidence assessment of the best available research evidence on the safety and effectiveness, cost effectiveness and budget impact of using Endovenous Laser Ablation (EVLA) or Endovenous Radiofrequency Ablation (RFA) in the management of symptomatic varicose…
| Arto Ohinmaa, Thanh Nguyen, Cheryl Barnabe, Liam Martin, Anthony Russell, Susan G Barr, Walter Maksymowych
OBJECTIVE: To provide Canadian estimates of health care utilization costs associated withrheumatoid arthritis (RA)-related and non-RA-related care within 4 treatment strategies and in different physical functioning categories.
| Cheryl Barnabe, Thanh Nguyen, Arto Ohinmaa, Joanne Homik, Susan G Barr, Liam Martin, Walter Maksymowych
OBJECTIVE: Sustained remission in rheumatoid arthritis (RA) results in healthcare utilizationcost savings. We evaluated the variation in estimates of savings when different definitions ofremission [2011 American College of Rheumatology/European League Against Rheumatism Boolean Definition, Simplified Disease Activity Index (SDAI) ≤ 3.3, Clinical Disease Activity Index…
Should vitamin B12 tablets be included in more Canadian drug formularies? An economic model of the cost-saving potential from increased utilisation of oral versus intramuscular vitamin B12 maintenance therapy for Alberta seniors. OBJECTIVE: The aim of this study was to estimate the cost-savings attainable if all patients aged ≥65 years in Alberta, Canada, currently on…
| 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 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.…
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…
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,…
| 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 STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report summarizes available key information on the use of bariatric treatments for adult obesity in Alberta and North America (mainly Canada). This analysis was intended to describe the profile of adult obesity (definition, progression, epidemiology, and population dynamics…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report examines the research evidence on the safety and efficacy of insulin pump therapy, as compared to multiple daily insulin injections, in the treatment of children, adults, and pregnant women diagnosed with type 1 diabetes. The report also analyses the economic impact…
| Bing Guo, Christa Harstall, Thomas Louie, Sander Veldhuyzen van Zanten, Levinus Dieleman
Aim: To critically appraise the clinical research evidence on the safety and effectiveness of FT compared with standard care in the treatment of patients with CDAD.
| Christa Harstall, Paul Taenzer, Donna Angus, Carmen Moga, Ann Scott, Tara Schuller
Rationale, Aims, and Objectives: A collaborative, multidisciplinary guideline adaptation process was developed to construct a single overarching, evidence-based clinical practice guideline (CPG) for all primary care practitioners responsible for the management of low back pain (LBP) to curb the use of ineffective treatments and improve patient outcomes. Note: This is an…
| Bing Guo, Christa Harstall, Thanh Nguyen, Arto Ohinmaa
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). Fecal transplantation for the treatment of Clostridium difficile-associated disease or ulcerative colitis examines the clinical research evidence on the safety and effects of fecal transplantation in the treatment of patients with Clostridium difficile-associated disease…
This article is an overview of systematic reviews reporting on the efficacy/effectiveness of psychotherapy and/or pharmacotherapy interventions delivered within Sex Offender Treatment (SOT) programs to reduce the risk of re-offending in convicted adult male sex offenders.
Related Report:
Treatment for Convicted Adult Male Sex Offenders
Reflecting the recent increased public awareness of the topic, this is the first and most comprehensive resource for over a decade on the molecular basis, prevalence, treatment options, socioeconomic impact, and prevention strategies of FASD. Edited by world-renowned experts, this compendium includes the latest research results to provide new insights and realistic estimations…
This health technology assessment report is an overview of systematic reviews reporting on the efficacy/effectiveness of psychotherapy and/or pharmacotherapy interventions delivered within Sex Offender Treatment (SOT) programs to reduce the risk of re-offending in convicted adult male sex offenders.
Information Specialist: Liz Dennett
This background document outlines the methods used to develop the Alberta Clinical Practice Guideline (CPG) for the Evidence-Informed Primary Care Management of Low Back Pain, which was produced as part of the second phase of the Alberta Health Technology Assessment (HTA) Ambassador Program.
Link to Alberta Ambassador Guideline Adaptation Program
Part of the successful Institute of Health Economics (IHE) book series, this handbook and ready reference adopts a unique approach in combining policy recommendations with specific treatment options for Parkinson patients. The first part of the book deals with the clinical medical, social and economical aspects of Parkinson Disease. These ten chapters include the latest diagnosis…
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 purpose of this report is to update an earlier HTA report published in 2003. This report examines the newly published clinical research evidence on the safety and efficacy/effectiveness of islet transplantation in type 1 diabetic patients who have severe hypoglycemia episodes or hyperglycemia unawareness but are without kidney failure. The main clinical efficacy/effectiveness…
L’honorable Michael Kirby (président de la Commission de la santé mentale du Canada) a présidé un éminent panel de citoyens et d’experts pour formuler des recommandations pratiques sur la façon d’améliorer la prévention, le diagnostic et le traitement des troubles dépressifs chez…
The Consensus Statement on Depression in Adults: How to Improve Prevention, Diagnosis and Treatment was produced by a panel of experts led by the Hon. Michael Kirby Chair, Mental Health Commission of Canada. This consensus statement was prepared by an independent panel of health professionals, academics, and public representatives based on: presentations by and questioning of experts…
Discussing all aspects of chronic pain management, this is the second volume of the new book series on health care and disease management, published with the Institute of Health Economics (IHE) in Edmonton, Canada. The authors provide an introduction into the history, pathophysiology, ethics and epidemiology of chronic pain before covering the different aspects of treating chronic…
Evidence of benefit from telemental health applications: a systematic review.
This review considers the evidence of benefit from use of telemental health (TMH) in studies that had clinical, economic, or administrative outcomes. The review also includes studies that provided information on the accuracy or feasibility of TMH.
Information Specialist: Janice Varney
Safety and efficacy of inhaled nitric oxide in the management of hypoxemic respiratory failure in adults with acute respiratory distress syndrome. This report was prepared in collaboration with the Health Technology Assessment program of the Institute of Health Economics, SEARCH Canada, and Calgary Health Region. It focuses on the published scientific evidence regarding the safety…
| Philip Jacobs, Arto Ohinmaa, Scott Klarenbach, Anderson Chuck, Raj Padwal, Janice Varney, Doug Lier
Institute of Health Economics Working Paper WP 06-01. The purpose of this report is to examine the economic issues associated with LGB. The following analyses were conducted: a systematic review of the economic literature on obesity-related interventions, with special attention to the differences between gastric bypass and gastric banding; an estimate of the Alberta population…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #37. The aim of this paper is to present the current evidence on the efficacy/effectiveness, safety, and efficiency of gastric electrical stimulation (EnterraTM Therapy System) used for the treatment of patients with severe gastroparesis (GP). Information Specialist: Liz Dennett NOTE: In 2006 the Alberta Heritage…
Alberta Heritage Foundation for Medical Research (AHFMR) Information Paper #26. The aim of this study was to determine whether laparoscopic adjustable gastric banding (LAGB) is a safe and effective procedure compared with open and/or laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic vertical banded gastroplasty (LVBG), especially in the longer term (> or = five…
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…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #35. The objective of this report is to assess the efficacy and safety of using trigger point injection (TPI) to treat patients with chronic non-malignant musculoskeletal pain, based on a systematic review of the current published evidence, and to determine the current state of the procedure, the feasibility of…
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…
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 Report #32. The aim of this report was to critically appraise and synthesise the published evidence regarding the short- and long-term efficacy/effectiveness of surgical techniques for patients with deep venous incompetence, and attendant skin changes/ulceration, that is refractory to standard care. Information Specialist:…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #31. This report was prepared in response to a request from Alberta Health and Wellness (AHW) for information about the use of islet cell transplantation for patients with type 1 diabetes. AHW was specifically interested in the current status of islet cell transplantation using the Edmonton protocol for a sub-population…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #30. Using the 1996 National Population Health survey data, this report provides an estimate of the prevalence of chronic pain (CP) among Albertans. It was estimated that 11.2% of Albertans suffer some level of CP and about 2.3% suffer from severe CP. As the proportion of individuals suffering from CP increases…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #27. This project is Part II of a request from several Regional Health Authorities and Alberta Health and Wellness, regarding two key objectives: to present information on the regulation of acupuncture in Alberta, including the scope of practice and coverage of services; and to conduct a systematic review of current…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #24. This report has been produced in response to a request from Alberta Health and Wellness for an update on the use of vagus nerve stimulation (VNS) for refractory epilepsy. The intent was to inform health policy makers, medical practitioners, and the public on the current status of the use of VNS for refractory…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #18. This report has been prepared following interest by the Alberta Cord Blood Bank in obtaining advice on the comparative effectiveness and costs of different types of stem cell transplantation. Earlier assessments by the Foundation have considered peripheral blood stem cell transplantation and cord blood transplantation.…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #17. The present report has been prepared as a follow up to the previous assessment because of continued interest in the technology by the health ministry and others. It considers studies that have been reported in the literature since completion of the earlier assessment (1997-1999) and focuses on the efficacy…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #19. A request for information about the use of low level laser therapy (LLLT) to assist wound healing was received from the Capital Health Authority (CHA). This technology has been increasingly used within the Edmonton area, with somewhat different approaches being taken by individual operators. The concern was…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #15. The present health technology assessment report has been prepared following a request by Alberta Health and Wellness for additional information on the use of stereotactic radiosurgery (SRS) in the treatment of acoustic neuroma, one of the applications considered in an earlier publication on SRS. Two main issues…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #14. This report has been prepared because of the interest by the Consumers' Association of Canada and the Health Ministry in the increasing use of newer types of intraocular lenses (IOLs) and in their comparative advantage. The focus of the report is on the safety, efficacy and effectiveness of the three types…
| 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 #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.…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #5. This assessment of computerized gait analysis in the management of children with cerebral palsy (CP) or spina bifida (SB) has been prepared at the request of the Glenrose Hospital, Edmonton. The hospital has already undertaken developmental work towards establishing a gait analysis facility. Advice was sought…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #3. The intent of this report is to inform medical practitioners and the public on the current status of in vitro fertilization and embryo transfer (IVF-ET) as a treatment for various types of infertility, and on its use and coverage in Canada. The report has been prepared because of the interest and debate regarding…