Although probabilistic analysis has become the accepted standard for decision analytic cost-effectiveness models, deterministic one-way sensitivity analysis continues to be used to meet the need of decision makers to understand the impact that changing the value taken by one specific parameter has on the results of the analysis. The value of a probabilistic form of one-way sensitivity…

Enzalutamide (Enza) is an effective treatment for metastatic castrate-resistant prostate cancer (mCPRC). However, Enza is not cost-effective (CE) at willingness to pay (WTP) thresholds from $0-$125 000/quality adjusted life years (QALYs) and is therefore a strain on valuable health care dollars. Metformin (Met) is inexpensive (~$8.00/month) and is thought to improve prostate cancer…

To examine the association between individual-level deprivation and health-related quality of life (HRQL) in the general population.

Acute lymphocytic leukemia (ALL) and acute myeloid leukemia (AML) are both hematological malignancies characterized by rapid onset. While AML is more common than ALL, both typically receive cytotoxic chemotherapy in first line. Upon complete remission, patients will be considered for allogeneic hematopoietic stem cell transplant (HSCT). The economic burden of malignant blood disorders…

CADTH Horizon Scanning bulletins present an overview of the technology and available evidence. They are not systematic reviews and do not involve critical appraisal, nor do they include a detailed summary of study findings. Therefore, they are not intended to provide recommendations for or against a particular technology.

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…

Pressure ulcers (PUs) are a burden to patients, carers and health-care providers. Specialist mattresses minimise the intensity and duration of pressure on vulnerable skin sites in at-risk patients.

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…

This study examined children’s health care service use, mothers’ workforce participation, and mothers’ community engagement based on children’s risk of developmental delay.

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).

The authors aimed to determine the cost effectiveness of initiating treatment early in the disease course (within 2 years of CD diagnosis) vs later in the disease course (more than 2 years after diagnosis). To do so, the authors constructed a Markov model of a hypothetical cohort of patients with CD in Canada to simulate disease progression after initiation of infliximab or adalimumab…

Low-density lipoprotein cholesterol (LDL-C) is an important indicator in the development and management of atherosclerotic cardiovascular disease (ASCVD). Herein, we describe the management of LDL-C with lipid-lowering therapy, among patients diagnosed with clinical ASCVD in Alberta, Canada.

The authors aimed to investigate whether 6-month adjuvant trastuzumab treatment is non-inferior to the standard 12-month treatment regarding disease-free survival.

The aim of this study is to describe how generic preference?based health?related quality of life (HRQoL) instruments have been used in research involving children with neurodevelopmental disorders (NDD).

The treatment landscape of multiple myeloma (MM) is rapidly evolving with the availability of new therapeutic options leading to improved responses and survival rates. The INFORMM study, an ongoing, province-wide study in Alberta, Canada (population of 4.3 million in 2018), is examining treatment patterns in a real-world setting using population-based administrative data to better…

The authors examined the cost-effectiveness of incorporating these assays into standard practice. A decision model was built to project lifetime clinical and economic consequences of different adjuvant treatment-guiding strategies. The model was parameterized using follow-up data from a secondary analysis of the Anastrozole or Tamoxifen Alone or Combined randomized trial, cost…

The clinical outcomes of patients with newly diagnosed multiple myeloma (NDMM) have improved. However, early mortality (EM) post-diagnosis remains a concern, with incidence ranging from 13% at 2 months to 29% at 1 year after diagnosis. EM can be influenced by patient age, comorbidities, performance status, therapy, and disease biology. Our aim is to examine EM incidence in patients…

Purpose: Growing up with a sibling with a neurodevelopmental disorder can have positive and negative effects on personal, social and emotional well-being; however, little is known about the impacts on unaffected siblings’ quality of life. The purpose of this review was to synthesize evidence from studies evaluating the quality of life of unaffected siblings of children with…

Abstract: Affecting 10–15% of women, postpartum depression (PPD) can be debilitating and costly. While early identification has the potential to improve timely care, recommendations regarding the implementation of routine screening are inconsistent. In Alberta, screening is completed using the Edinburgh Postnatal Depression Scale during public health well child clinic visits.…

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…

Education of women regarding healthy lifestyle choices is an important function for prenatal care providers. Within Canada, women choose to receive pregnancy care from one of a variety of publicly funded care providers. This study examines the association between the type of care provider(s) seen during pregnancy and the provision of advice related to nutrition, weight management,…

Comment in: The Inclusion of Spillover Effects in Economic Evaluation: A Public Health Economics Perspective

Early detection of neurodevelopmental disorders (NDDs) enables access to early interventions for children. We assess the Ages and Stages Questionnaire (ASQ)’s ability to identify children with a NDD in population data.

Yearly, 450 000 pregnant Canadians are eligible for voluntary prenatal screening for trisomy 21. Different screening strategies select approximately 4% of women for invasive fetal chromosome testing. Non-invasive prenatal testing (NIPT) using maternal blood cell-free DNA could reduce those invasive procedures but is expensive. This study evaluated the cost-effectiveness…

Economic evaluation is a tool used to inform decision makers on the efficiency of comparative healthcare interventions and inform resource allocation decisions. There is a growing need for the use of economic evaluations to assess the value of interventions for children with neurodevelopmental disorders (NDDs), a population that has increasing demands for healthcare services. Unfortunately,…

An increasing number of family service agencies and community-based mental health service providers are implementing a single-session walk-in counselling (SSWIC) as an alternative to traditional counselling. However, few economic evaluations have been undertaken.

Precision medicine is heralded as offering more effective treatments to smaller targeted patient populations. In breast cancer, adjuvant chemotherapy is standard for patients considered as high-risk after surgery. Molecular tests may identify patients who can safely avoid chemotherapy. The objective of this paper is to use economic analysis before a large-scale clinical trial of…

The volume and technical complexity of both academic and commercial research using decision analytic modelling has increased rapidly over the last two decades. The range of software programs used for their implementation has also increased, but it remains true that a small number of programs account for the vast majority of cost-effectiveness modelling work. We report a comparison…

Regulation makes economic sense, argue Douglas Sipp, Christopher McCabe and John E. J. Rasko.