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),…
| Thomas Lange
A healthy mouth is an essential ingredient for overall good health, but a Canadian’s access to comprehensive dental care is dependent on their ability to attain private insurance. This paper seeks to estimate the gross and net total cost of two policy options for introducing comprehensive dental care into Canadian Medicare. Using a micro-costing approach for estimating the…
| Thomas Lange
This paper presents a formulaic approach to micro-costing the expected direct clinical cost of a given public dental program in Canada. A micro-costing approach enables policy leaders to create or radically redesign existing public-sector dental programs by projecting the total cost generated by expected clinical demand. Current public dental plans employ heavy restrictions around…
The recent report by Alberta’s Blue ribbon panel on the province’s finances denounced Alberta’s Fee-for-Service (FFS) model as a significant source of inefficiency and cost within the health system, going as far as to suggest legislating a non-FFS model. If pursued, Alberta would be the first province since the start of Canadian Medicare to fully shift away from…
| Amity Quinn, Braden Manns, Brenda Hemmelgarn, Flora Au, Marcello Tonelli, Peter Faris, Aaron J Trachtenberg, Jianguo Zhang, Scott Klarenbach, Robert G. Weaver
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.
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…
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…
| Amity Quinn, Braden Manns, Brenda Hemmelgarn, Flora Au, Marcello Tonelli, Robert G. Weaver, Scott Klarenbach, Helen So
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…
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…