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The burden of illness of osteoporosis in Canada.

https://arctichealth.org/en/permalink/ahliterature126333
Source
Osteoporos Int. 2012 Nov;23(11):2591-600
Publication Type
Article
Date
Nov-2012
Author
J-E Tarride
R B Hopkins
W D Leslie
S. Morin
J D Adachi
A. Papaioannou
L. Bessette
J P Brown
R. Goeree
Author Affiliation
Programs for Assessment of Technology in Health (PATH) Research Institute, St Joseph's Healthcare Hamilton, 25 Main Street West, Suite 2000, Hamilton, ON, L8P 1H1, Canada. tarride@mcmaster.ca
Source
Osteoporos Int. 2012 Nov;23(11):2591-600
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Aged
Bone Density Conservation Agents - economics - therapeutic use
Canada - epidemiology
Cost of Illness
Drug Costs - statistics & numerical data
Emergency Service, Hospital - economics - statistics & numerical data
Female
Health Care Costs - statistics & numerical data
Home Care Services - economics - statistics & numerical data
Hospitalization - economics - statistics & numerical data
Humans
Long-Term Care - economics
Male
Middle Aged
Osteoporosis - economics - epidemiology - therapy
Osteoporotic Fractures - economics - epidemiology - therapy
Prevalence
Sensitivity and specificity
Abstract
To update the 1993 burden of illness of osteoporosis in Canada, administrative and community data were used to calculate the 2010 costs of osteoporosis at $2.3 billion in Canada or 1.3% of Canada's healthcare expenditures. Prevention of fractures in high-risk individuals is key to decrease the financial burden of osteoporosis.
Since the 1996 publication of the burden of osteoporosis in 1993 in Canada, the population has aged and the management of osteoporosis has changed. The study purpose was to estimate the current burden of illness due to osteoporosis in Canadians aged 50 and over.
Analyses were conducted using five national administrative databases from the Canadian Institute for Health Information for the fiscal-year ending March 31 2008 (FY 2007/2008). Gaps in national data were supplemented by provincial and community data extrapolated to national levels. Osteoporosis-related fractures were identified using a combination of most responsible diagnosis at discharge and intervention codes. Fractures associated with severe trauma codes were excluded. Costs, expressed in 2010 dollars, were calculated for osteoporosis-related hospitalizations, emergency care, same day surgeries, rehabilitation, continuing care, homecare, long-term care, prescription drugs, physician visits, and productivity losses. Sensitivity analyses were conducted to measure the impact on the results of key assumptions.
Osteoporosis-related fractures were responsible for 57,413 acute care admissions and 832,594 hospitalized days in FY 2007/2008. Acute care costs were estimated at $1.2 billion. When outpatient care, prescription drugs, and indirect costs were added, the overall yearly cost of osteoporosis was over $2.3 billion for the base case analysis and as much as $3.9 billion if a proportion of Canadians were assumed to be living in long-term care facilities due to osteoporosis.
Osteoporosis is a chronic disease that affects a large segment of the adult population and results in a substantial economic burden to the Canadian society.
Notes
Cites: Osteoporos Int. 2008 Mar;19(3):269-7618060586
Cites: Osteoporos Int. 2008 Jan;19(1):79-8617641811
Cites: Osteoporos Int. 2009 May;20(5):703-1418802659
Cites: CMAJ. 2009 Sep 1;181(5):265-7119654194
Cites: Osteoporos Int. 2010 Aug;21(8):1317-2219802507
Cites: CMAJ. 2010 Nov 23;182(17):1864-7320940232
Cites: Appl Health Econ Health Policy. 2011 Mar 1;9(2):111-2321271750
Cites: Osteoporos Int. 2011 Jun;22(6):1835-4421165602
Cites: Age Ageing. 2011 Sep;40(5):602-721775335
Cites: J Bone Miner Res. 2011 Oct;26(10):2411-821710615
Cites: Osteoporos Int. 2012 Jun;23(6):1757-6821927921
Cites: CMAJ. 2002 Nov 12;167(10 Suppl):S1-3412427685
Cites: J Bone Miner Res. 1997 Jan;12(1):24-359240722
Cites: Osteoporos Int. 2005 Feb;16(2):222-815232678
Cites: Osteoporos Int. 2005 Mar;16 Suppl 2:S8-S1715378232
Cites: Osteoporos Int. 2005 Dec;16(12):1475-8016217587
Cites: Osteoporos Int. 2007 Jan;18(1):77-8417048064
Cites: JAMA. 2007 Nov 28;298(20):2381-818042915
Cites: Contemp Clin Trials. 2008 Mar;29(2):194-21017766187
PubMed ID
22398854 View in PubMed
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The economic burden of schizophrenia in Canada in 2004.

https://arctichealth.org/en/permalink/ahliterature171441
Source
Curr Med Res Opin. 2005 Dec;21(12):2017-28
Publication Type
Article
Date
Dec-2005
Author
R. Goeree
F. Farahati
N. Burke
G. Blackhouse
D. O'Reilly
J. Pyne
J-E Tarride
Author Affiliation
Program for Assessment of Technology in Health, St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada. goereer@mcmaster.ca
Source
Curr Med Res Opin. 2005 Dec;21(12):2017-28
Date
Dec-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada - epidemiology
Cost of Illness
Female
Health Care Costs
Health Services - utilization
Humans
Male
Middle Aged
Schizophrenia - economics - epidemiology - mortality
Abstract
To estimate the financial burden of schizophrenia in Canada in 2004.
A prevalence-based cost-of-illness (COI) approach was used. The primary sources of information for the study included a review of the published literature, a review of published reports and documents, secondary analysis of administrative datasets, and information collected directly from various federal and provincial government programs and services. The literature review included publications up to April 2005 reported in MedLine, EMBASE and PsychINFO. Where specific information from a province was not available, the method of mean substitution from other provinces was used. Costs incurred by various levels/departments of government were separated into healthcare and non-healthcare costs. Also included in the analysis was the value of lost productivity for premature mortality and morbidity associated with schizophrenia. Sensitivity analysis was used to test major cost assumptions used in the analysis. Where possible, all resource utilization estimates for the financial burden of schizophrenia were obtained for 2004 and are expressed in 2004 Canadian dollars (CAN dollars).
The estimated number of persons with schizophrenia in Canada in 2004 was 234 305 (95% CI, 136 201-333 402). The direct healthcare and non-healthcare costs were estimated to be 2.02 billion CAN dollars in 2004. There were 374 deaths attributed to schizophrenia. This combined with the high unemployment rate due to schizophrenia resulted in an additional productivity morbidity and mortality loss estimate of 4.83 billion CAN dollars, for a total cost estimate in 2004 of 6.85 billion CAN dollars. By far the largest component of the total cost estimate was for productivity losses associated with morbidity in schizophrenia (70% of total costs) and the results showed that total cost estimates were most sensitive to alternative assumptions regarding the additional unemployment due to schizophrenia in Canada.
Despite significant improvements in the past decade in pharmacotherapy, programs and services available for patients with schizophrenia, the economic burden of schizophrenia in Canada remains high. The most significant factor affecting the cost of schizophrenia in Canada is lost productivity due to morbidity. Programs targeted at improving patient symptoms and functioning to increase workforce participation has the potential to make a significant contribution in reducing the cost of this severe mental illness in Canada.
PubMed ID
16368053 View in PubMed
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Estimating the excess costs for patients with incident fractures, prevalent fractures, and nonfracture osteoporosis.

https://arctichealth.org/en/permalink/ahliterature124525
Source
Osteoporos Int. 2013 Feb;24(2):581-93
Publication Type
Article
Date
Feb-2013
Author
R B Hopkins
J E Tarride
W D Leslie
C. Metge
L M Lix
S. Morin
G. Finlayson
M. Azimaee
E. Pullenayegum
R. Goeree
J D Adachi
A. Papaioannou
L. Thabane
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, Faculty of Health Science, McMaster University, Hamilton, ON, Canada. hopkinr@mcmaster.ca
Source
Osteoporos Int. 2013 Feb;24(2):581-93
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Case-Control Studies
Female
Health Care Costs - statistics & numerical data
Health Resources - utilization
Health Services Research - methods
Humans
Incidence
Male
Manitoba - epidemiology
Middle Aged
Osteoporosis - economics - epidemiology
Osteoporosis, Postmenopausal - economics - epidemiology
Osteoporotic Fractures - economics - epidemiology
Prevalence
Sex Factors
Abstract
Based on a population age 50+, significant excess costs relative to matched controls exist for patients with incident fractures that are similar in relative magnitude to other chronic diseases such as stroke or heart disease. Prevalent fractures also have significant excess costs that are similar in relative magnitude to asthma/chronic obstructive pulmonary disease.
Cost of illness studies for osteoporosis that only include incident fractures may ignore the long-term cost of prevalent fractures and primary preventive care. We estimated the excess costs for patients with incident fractures, prevalent fractures, and nonfracture osteoporosis relative to matched controls.
Men and women age 50+ were selected from administrative records in the province of Manitoba, Canada for the fiscal year 2007-2008. Three types of cases were identified: (1) patients with incident fractures in the current year (2007-2008), (2) patients with prevalent fractures in previous years (1995-2007), and (3) nonfracture osteoporosis patients identified by specific pharmacotherapy or low bone mineral density. Excess resource utilization and costs were estimated by subtracting control means from case means.
Seventy-three percent of provincial population age 50+ (52 % of all men and 91 % of all women) were included (121,937 cases, 162,171 controls). There were 3,776 cases with incident fracture (1,273 men and 2,503 women), 43,406 cases with prevalent fractures (15,784 men and 27,622 women) and 74,755 nonfracture osteoporosis cases (7,705 men and 67,050 women). All incident fractures had significant excess costs. Incident hip fractures had the highest excess cost: men $44,963 (95 % CI: $38,498-51,428) and women $45,715 (95 % CI: $36,998-54,433). Prevalent fractures (other than miscellaneous or wrist fractures) also had significant excess costs. No significant excess costs existed for nonfracture osteoporosis.
Significant excess costs exist for patients with incident fractures and with prevalent hip, vertebral, humerus, multiple, and traumatic fractures. Ignoring prevalent fractures underestimate the true cost of osteoporosis.
PubMed ID
22572964 View in PubMed
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Estimation of the lifetime risk of hip fracture for women and men in Canada.

https://arctichealth.org/en/permalink/ahliterature134642
Source
Osteoporos Int. 2012 Mar;23(3):921-7
Publication Type
Article
Date
Mar-2012
Author
R B Hopkins
E. Pullenayegum
R. Goeree
J D Adachi
A. Papaioannou
W D Leslie
J E Tarride
L. Thabane
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, Faculty of Health Science, McMaster University, Hamilton, ON, Canada. hopkinr@mcmaster.ca
Source
Osteoporos Int. 2012 Mar;23(3):921-7
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Canada - epidemiology
Female
Hip Fractures - epidemiology - mortality
Humans
Life tables
Male
Middle Aged
Osteoporotic Fractures - epidemiology - mortality
Risk Assessment - methods
Sex Distribution
Abstract
In Canada in 2008, based on current rates of fracture and mortality, a woman or man at age 50 years will have a projected lifetime risk of fracture of 12.1% and 4.6%, respectively, and 8.9% and 6.7% after incorporating declining rates of hip fracture and increases in longevity.
In 1989, the lifetime risk of hip fractures in Canada was 14.0% (women) and 5.2% (men). Since then, there have been changes in rates of hip fracture and increased longevity. We update these estimates to 2008 adjusted for these trends, and in addition, we estimated the lifetime risk of first hip fracture.
We used national administrative data from fiscal year April 1, 2007 to March 31, 2008 to identify all hip fractures in Canada. We estimated the crude lifetime risk of hip fracture for age 50 years to end of life using life tables. We projected lifetime risk incorporating national trends in hip fracture and increased longevity from Poisson regressions. Finally, we removed the percentage of second hip fractures to estimate the lifetime risk of first hip fracture.
From April 1, 2007 to March 31, 2008, there were 21,687 hip fractures, 15,742 (72.6%) in women and 5,945 (27.4%) in men. For women and men, the crude lifetime risk was 12.1% (95%CI, 12.1, 12.2%) and 4.6% (95%CI, 4.5, 4.7%), respectively. When trends in mortality and hip fractures were both incorporated, the lifetime risk of hip fracture were 8.9% (95%CI, 2.3, 15.4%) and 6.7% (95%CI, 1.2, 12.2%). The lifetime risks for first hip fracture were 7.3% (95%CI, 0.8, 13.9%) and 6.2% (95%CI, 0.7, 11.7%).
The lifetime risk of hip fracture has fallen from 1989 to 2008 for women and men. Adjustments for trends in mortality and rates of hip fracture with removing second fractures produced non-significant differences in estimates.
PubMed ID
21557096 View in PubMed
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A multinational pharmacoeconomic evaluation of acute major depressive disorder (MDD): a comparison of cost-effectiveness between venlafaxine, SSRIs and TCAs.

https://arctichealth.org/en/permalink/ahliterature10098
Source
Value Health. 2001 Jan-Feb;4(1):16-31
Publication Type
Article
Author
J J Doyle
J. Casciano
S. Arikian
J E Tarride
M A Gonzalez
R. Casciano
Author Affiliation
Columbia University, School of Public Health, New York, NY, USA. jdoyle@groupanalytica.com
Source
Value Health. 2001 Jan-Feb;4(1):16-31
Language
English
Publication Type
Article
Keywords
Antidepressive Agents, Second-Generation - economics - therapeutic use
Antidepressive Agents, Tricyclic - economics - therapeutic use
Budgets
Comparative Study
Cost-Benefit Analysis
Cyclohexanols - economics - therapeutic use
Decision Trees
Depressive Disorder, Major - drug therapy - economics
Drug Costs - statistics & numerical data
Economics, Pharmaceutical - statistics & numerical data
Europe
Health Services Research - methods
Humans
Insurance, Health, Reimbursement
Monte Carlo Method
Research Support, Non-U.S. Gov't
Serotonin Uptake Inhibitors - economics - therapeutic use
United States
Venezuela
Abstract
METHODS: We conducted a multinational pharmacoeconomic evaluation comparing the immediate release form of a new class of serotonin norepinephrine reuptake inhibitor (SNRI), venlafaxine IR to the selective serotonin reuptake inhibitors (SSRIs) and the tricyclic antidepressants (TCAs) in the treatment of acute major depressive disorder (MDD) in 10 countries (Germany, Italy, Netherlands, Poland, Spain, Sweden, Switzerland, United Kingdom, United States, and Venezuela). We designed a decision analytic model assessing the acute phase of MDD treatment within a 6-month time horizon. Six decision tree models were customized with country-specific estimates from a clinical management analysis, meta-analytic rates from two published meta-analyses, and a resource valuation of treatment costs representing the inpatient and outpatient settings within each country. The meta-analyses provided the clinical rates of success defined as a 50% reduction in depression scores on the Hamilton Depression Scale (HAM-D) or the Montgomery-Asberg Depression Rating Scale (MADRS). Treatment regimen costs were determined from standard lists, fee schedules, and communication with local health economists in each country. The meta-analytic rates were applied to the decision analytic model to calculate the expected cost and expected outcomes for each antidepressant comparator. Cost-effectiveness was determined using the expected values for both a successful outcome, and a composite measure of outcome termed symptom-free days. A policy analysis was conducted to examine the health system budget impact in each country of increasing the utilization of the most effective antidepressant found in our study. RESULTS: Initiating treatment of MDD with venlafaxine IR yielded a lower expected cost compared to the SSRIs and TCAs in all countries except Poland in the inpatient setting, and Italy and Poland within the outpatient settings. The weighted average expected cost per patient varied from US$632 (Poland) to US$5647 (US) in the six-month acute phase treatment of MDD. The estimated total budgetary impact for each 1% of venlafaxine utilization, assuming a population of one million MDD patients, ranged from US$1600 (Italy) to US$29,049 (US). CONCLUSIONS: Within the inpatient and outpatient treatment settings, venlafaxine IR was a more cost-effective treatment of MDD compared to the SSRIs and TCAs. Additionally, the results of this investigation indicate that increased utilization of venlafaxine in most settings across Europe and the Americas will have favorable impact on health care payer budgets. ADR, adverse drug reaction; CMA, clinical management analysis; ECT, electroconvulsive therapy; HAM-D, Hamilton Depression Scale; MADRS, Montgomery-Asberg depression rating scale; MDD, major depressive disorder; SFD, symptom-free day; SNRI, serotonin-norepinephrine reuptake inhibitor; SSRI, selective serotonin reuptake inhibitor; TCA, tricyclic antidepressant; WHO, world health organization.
PubMed ID
11704969 View in PubMed
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Painful neuropathic disorders: an analysis of the Régie de l'Assurance Maladie du Québec database.

https://arctichealth.org/en/permalink/ahliterature164561
Source
Pain Res Manag. 2007;12(1):31-7
Publication Type
Article
Date
2007
Author
J. Lachaine
A. Gordon
M. Choinière
J P Collet
D. Dion
J-E Tarride
Author Affiliation
University of Montreal, Montreal, Quebec, Canada. jean.lachaine@umontreal.ca
Source
Pain Res Manag. 2007;12(1):31-7
Date
2007
Language
English
Publication Type
Article
Keywords
Analgesics - therapeutic use
Comorbidity
Costs and Cost Analysis
Databases, Factual
Drug Utilization Review
Female
Health Services - economics - utilization
Humans
Male
Medication Errors - statistics & numerical data
Middle Aged
Neuralgia - drug therapy - economics
Quebec
Abstract
Painful neuropathic disorders (PNDs) refer to neurological disorders involving nerves in which pain is a predominant symptom. In most cases, PNDs involve the peripheral nerves. Treatment of PNDs is likely to use large health care resources. However, little is known about the economic burden of PNDs in Canada.
The present study was performed using data from a random sample of patients covered by the Régie de l'Assurance Maladie du Quebec drug plan. Subjects with a diagnosis of a peripheral PND were identified. Comorbidities, pain-related medication use and resource utilization were compared between PND patients and control patients without PNDs matched for age and sex in a 1:1 ratio.
A total of 4912 patients with PNDs were identified. A higher level of comorbidities was found in the PND group (Von Korff chronic disease score 3.91 versus 2.54; P
Notes
Cites: Clin J Pain. 2000 Jun;16(2 Suppl):S101-510870748
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Cites: Eur J Pain. 2001;5(4):379-8911743704
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Cites: Pain. 2001 Nov;94(2):215-2411690735
PubMed ID
17372632 View in PubMed
Less detail

Partnership in employee health. A workplace health program for British Columbia Public Service Agency (Canada).

https://arctichealth.org/en/permalink/ahliterature129201
Source
Work. 2011;40(4):459-71
Publication Type
Article
Date
2011
Author
J E Tarride
K. Harrington
R. Balfour
P. Simpson
L. Foord
L. Anderson
W. Lakey
Author Affiliation
Programs for Assessment of Technology in Health Research Institute, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada. tarride@mcmaster.ca
Source
Work. 2011;40(4):459-71
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
British Columbia
Female
Health Promotion - economics
Humans
Male
Mass Screening
Metabolic Syndrome X - diagnosis - etiology - prevention & control
Middle Aged
Occupational Health - economics
Patient Education as Topic
Program Evaluation
Risk assessment
Risk factors
Workplace
Abstract
To evaluate the My Health Matters! (MHM) program, a multifaceted workplace intervention relying on education and awareness, early detection and disease management with a focus on risk factors for metabolic syndrome.
The MHM program was offered to 2,000 public servants working in more than 30 worksites in British Columbia, Canada.
The MHM program included a health risk assessment combined with an opportunity to attend an on-site screening and face-to-face call back visits and related on-site educational programs. Clinical and economic outcomes were collected over time in this one-year prospective study coupled with administrative and survey data.
Forty three per cent of employees (N=857) completed the online HRA and 23 per cent (N=447) attended the initial clinical visit with the nurse. Risk factors for metabolic syndrome were identified in more than half of those attending the clinical visit. The number of risk factors significantly decreased by 15 per cent over six months (N=141). The cost per employee completing the HRA was $205 while the cost per employee attending the initial clinical visit was $394. Eighty-two per cent of employees would recommend the program to other employers.
This study supports that workplace interventions are feasible, sustainable and valued by employees. As such, this study provides a new framework for implementing and evaluating workplace interventions focussing on metabolic disorders.
PubMed ID
22130063 View in PubMed
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7 records – page 1 of 1.