Community Health Workers (CHWs) play a vital role delivering health services to vulnerable populations in low resource settings. In Rwanda, CHWs provide village-level care focused on maternal/child health, control of infectious diseases, and health education, but do not receive salaries for these services. CHWs make up the largest single group involved in health delivery in the…
To monitor the magnitude of the drug shortage problem in Canada, since 2017, Health Canada has required manufacturers to report drug shortages. This study aimed to identify the factors associated with drug shortages in Canada.
The clinical trial landscape for Coronavirus 2019 (COVID-19) is radically different from that of previous epidemics. Compared with H1N1, Ebola, and Zika, COVID-19 had an order of magnitude more clinical trials within the first 3 months following the declaration of a Public Health Emergency of International Concern (PHEIC). These trials have started much faster, are more geographically…
The scarcity of novel antibiotic compounds in a time of increasing resistance rates has begun to ring alarm bells at the highest echelons of government. Large new financial incentives to accelerate antibiotic research and development, such as market entry rewards (MERs), are being considered. However, there is little focus on how to sustain the efficacy of new, promising antibiotics…
Impact of isolation precautions on psychological wellbeing of patients has yet to be fully quantified. To assess the impact of isolation precautions on patients' health-related quality of life and depression or anxiety scales and estimate per day cost of anxiety and depression. Literature pertaining to impact of isolation precautions was searched on EMBASE and PubMed databases…
Many countries continue to consider implementing a universal chickenpox vaccine program; however, there is no consensus on the most appropriate and effective timing between vaccine doses. The chickenpox vaccine schedule debate is highlighted in Canada, where there are currently eight different vaccine schedules across the country. The objective of this study was to test the overall…
To examine the association between individual-level deprivation and health-related quality of life (HRQL) in the general population.
Overconsumption of sugar-sweetened beverages (SSBs) contributes to childhood and adult obesity and numerous related diseases, including heart disease, strokes, cancers, and type 2 diabetes. It also increases healthcare costs. Sugary drink taxes have been implemented in several countries to curb sugar intake. However, there is a concern that sugary drink taxes are regressive. This…
Methicillin-resistant Staphylococcus aureus (MRSA) is an opportunistic bacterial organism resistant to first line antibiotics. Acquisition of MRSA is often classified as either healthcare-associated or community-acquired. It has been shown that both healthcare-associated and community-acquired infections contribute to the spread of MRSA within healthcare facilities. The objective…
In June 2015, Alberta, Canada instituted a universal publicly funded rotavirus vaccination programme (Rotarix, RV1), with vaccine doses scheduled for 2 and 4months of age. Vaccination was restricted so that infants were only allowed to receive first dose between 6 and 20 weeks of age, and second dose before eight calendar months of age. We assessed the coverage and schedule non-compliance…
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…
| Aidan Hollis
A common narrative is that high prices are necessary for "orphan drugs" because of the fewer patients. In the context of state health insurance systems, the high prices create significant challenges because of limited budgets.
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.
The EQ-5D-5 L and the SF-12 are the most commonly used generic measures of health-related quality of life among people with arthritis. However, there is little evidence on the extent to which the individual dimensions and domains of these instruments perform among this population. The objective was to examine the discriminative validity of the EQ-5D-5 L and the SF-12…
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…
High orphan drug prices have gained the attention of payers and policy makers. These prices may reflect the need to recoup the cost of drug development from a small patient pool. However, estimates of the cost of orphan drug development are sparse.
It is the first whole diet comparison using Canada’s best dietary data spanning from 2004 to 2015 and showing a modest improvements in diet quality. The economic burden of unhealthy eating is enormous. In 2004 this was estimated for Canada to be $ 3.2 Billion per year. Due to the modest improvements in diet quality it came down with $ 219 million by 2015. Policy and decision…
To assess vaccine coverage for a cohort of children who have been in the care of the child welfare system compared to children in the general population.
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.
Biological interactions between varicella (chickenpox) and herpes zoster (shingles), two diseases caused by the varicella zoster virus (VZV), continue to be debated including the potential effect on shingles cases following the introduction of universal childhood chickenpox vaccination programs. We investigated how chickenpox vaccination in Alberta impacts the incidence and age-distribution…
Few studies have estimated the economic burden of chronic diseases (e.g., type 2 diabetes, cardiovascular diseases, cancers) attributable to unhealthy eating. In this study, we estimated the economic burden of chronic disease attributable to not meeting Canadian food recommendations. We first obtained chronic disease risk estimates for intakes of both protective (1. vegetables;…
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.
| Aidan Hollis
Following lengthy negotiations with the European Union (EU), Canada enacted Bill C-30 to implement the ‘Comprehensive Economic and Trade Agreement’ in 2016 [1]. A particularly important part of that legislation involved the treatment of pharmaceutical exclusivity and the process of litigation between patentees and generic firms. This paper reviews the likely impact…
This study aims to summarise and describe the evolution of published economic evaluations of vaccines in Canada, thereby outlining the current state of this expanding and meaningful research.
Cost is a critical element in almost all public or private decisions regarding health care and human services. While cost as “opportunity cost” is straightforward on a conceptual level, making the concept operational, quantifying costs and integrating such information into decision analysis is a continuing challenge. An IHE conference, “On the State of the Art…