Objectives To assess whether recently-proposed alternatives to the quality-adjusted life year (QALY), intended to address concerns about discrimination, are suitable for informing resource allocation decisions. Methods We consider two alternatives to the QALY: the Health Years in Total (HYT), recently proposed by Basu et al., and the Equal Value of Life Years Gained (evLYG),…

There is limited information about the impact of frailty on public payer costs in cardiac surgery. This study aimed to determine quality-adjusted life-years (QALYs) and costs associated with pre-operative frailty in patients referred for cardiac surgery.

Physician payment models are perceived to be an important strategy for improving health, access, quality, and the value of health care. Evidence is predominantly from primary care, and little is known regarding whether specialists respond similarly. We conducted a systematic review to synthesize evidence on the impact of specialist physician payment models across the domains of…

Health care payers are interested in policy-level interventions to increase peritoneal dialysis use in end-stage renal disease. We examined whether increases in physician remuneration for peritoneal dialysis were associated with greater peritoneal dialysis use.

Question  Is a specialist physician payment model associated with visit frequency, quality of care, and costs for people with chronic disease? Findings  In this population-based cohort study that included a propensity-score matched cohort of 31?898 adults with diabetes or chronic kidney disease seen by 489 physicians, there was no statistical evidence of a difference…

Canada recently entered into two multinational trade agreements (i.e., the Canada, United States, and Mexico Trade Agreement; and the Comprehensive Economic and Trade Agreement with the European Union). The resulting federal policy changes will prolong periods of market protection afforded to eligible brand-name prescription drugs by extending competition-blocking patent and data…

Health Technology Assessment (HTA) has always sought to incorporate the evidence of all patients affected in the decision-making process. While health system budgets could increase to cover costs of new technologies, the relevant patients are those benefitting from access to the technology being appraised. More recently, with health system budgets effectively fixed, costs of new…

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.

As the adverse clinical outcomes common in patients with chronic kidney disease (CKD) can be prevented or delayed, information on the cost of care across the spectrum of CKD can inform investments in CKD care.

Most pharmaceutical expenditure in Canada is private. In 2017, Canadian provincial, territorial and federal governments were reported to have spent $14.5 billion on pharmaceuticals, accounting for only 43% of total pharmaceutical expenditure.1 A combination of private insurance and patient expenditures in the form of direct payment for pharmaceuticals, deductibles and other…

Background: As the number of people with chronic diseases increases, understanding the impact of payment model on the types of patients seen by specialists has implications for improving the quality and value of care. We sought to determine if there is an association between the specialist physician payment model and the types of patients seen.

Little is known about 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.

Little is known about the cost burden of acute myocardial infarction (AMI) on healthcare systems. Accordingly, we examined the long-term trends of healthcare costs for AMI in the province of Alberta, Canada.

The recently released Canadian cardiac care quality indicators include 30-day in-hospital mortality and readmission rates after percutaneous coronary intervention (PCI) and isolated coronary artery bypass grafting (CABG). We examined long-term trends and provincial variations in these outcomes among acute myocardial infarction (AMI) patients.

Healthcare providers, managers and policy-makers in many jurisdictions are focused on a common goal: optimizing value and quality of care provided to their citizens within a resource envelope. Health technology reassessment is a structured, evidence-based assessment of the clinical, social, ethical and economic effects of a technology currently used in the healthcare system to…

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.