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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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A Canadian physician survey of dyspepsia management.

https://arctichealth.org/en/permalink/ahliterature205984
Source
Can J Gastroenterol. 1998 Jan-Feb;12(1):83-90
Publication Type
Article
Author
N. Chiba
L. Bernard
B J O'Brien
R. Goeree
R H Hunt
Author Affiliation
Surrey GI Clinic, Guelph, Ontario. chiban@fhs.mcmaster.ca
Source
Can J Gastroenterol. 1998 Jan-Feb;12(1):83-90
Language
English
Publication Type
Article
Keywords
Adult
Canada
Drug Therapy, Combination
Dyspepsia - drug therapy - microbiology
Family Practice - statistics & numerical data
Helicobacter Infections - complications - drug therapy - microbiology
Helicobacter pylori
Humans
Physician's Practice Patterns - statistics & numerical data
Questionnaires
Referral and Consultation
Abstract
To determine the management of patients with new onset dyspepsia by Canadian family physicians.
A survey was mailed to 195 family physicians in August 1995 to identify how they manage dyspepsia in patients according to four scenarios: based on presenting symptoms alone; assuming Helicobacter pylori-positive; known to be H pylori-negative; and endoscopically confirmed nonulcer dyspepsia.
A total of 170 of 195 physicians (87.2%) completed the survey. Physicians reported that 7.3% of their practice is devoted to dyspepsia and 23% of these dyspeptic patients present for the first time. Ninety-three per cent of family physicians find a symptom classification of ulcer-, reflux- and dysmotility-like dyspepsia helpful. The majority of patients are advised to make life-style changes and are treated with antacids or empiric drug therapy. A H2 receptor antagonist was the drug of choice for ulcer and reflux-like dyspepsia, while prokinetics were often used for reflux and dysmotility-like dyspepsia. After failure of initial treatment, patients were given another course of empiric treatment, commonly with cisapride or omeprazole. Family physicians estimated that the mean time to obtain a gastrointestinal consult was five weeks, and 70% indicated that this time to consult adversely influenced their decision to refer. If this time was reduced to less than two weeks, responding physicians would consider referring all eligible patients. On average, two to 2.5 courses of empiric therapy were given before referral. If H pylori status was known, fewer empiric treatments (mean 1.8) were given before gastroenterological referral compared with the other scenarios. If the patient had nonulcer dyspepsia, 30% of family physicians provided reassurance only and did not prescribe empiric drug treatment.
Most newly dyspeptic patients in Canada are treated with empiric therapy according to symptom classification and referred for endoscopy after an average two to 2.5 treatment courses.
PubMed ID
9544418 View in PubMed
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Cost-effectiveness of denosumab in the treatment of postmenopausal osteoporosis in Canada.

https://arctichealth.org/en/permalink/ahliterature120144
Source
J Med Econ. 2012;15 Suppl 1:3-14
Publication Type
Article
Date
2012
Author
D. Chau
D L Becker
M E Coombes
G. Ioannidis
J D Adachi
R. Goeree
Author Affiliation
Amgen Canada Inc, Mississauga, Ontario, Canada.
Source
J Med Econ. 2012;15 Suppl 1:3-14
Date
2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alendronate - economics - therapeutic use
Antibodies, Monoclonal, Humanized - economics - therapeutic use
Bone Density Conservation Agents - economics - therapeutic use
Cohort Studies
Cost-Benefit Analysis
Etidronic Acid - analogs & derivatives - economics - therapeutic use
Female
Humans
Markov Chains
Middle Aged
Models, Econometric
Ontario
Osteoporosis, Postmenopausal - drug therapy
Quality-Adjusted Life Years
Abstract
Denosumab is a novel biologic agent approved in Canada for treatment of post-menopausal osteoporosis (PMO) in women at high risk for fracture or who have failed or are intolerant to other osteoporosis therapies. This study estimated cost-effectiveness of denosumab vs usual care from the perspective of the Ontario public payer.
A previously published PMO Markov cohort model was adapted for Canada to estimate cost-effectiveness of denosumab. The primary analysis included women with demographic characteristics similar to those from the pivotal phase III denosumab PMO trial (FREEDOM; age 72 years, femoral neck BMD T-score -2.16 SD, vertebral fracture prevalence 23.6%). Three additional scenario sub-groups were examined including women: (1) at high fracture risk, defined in FREEDOM as having at least two of three risk factors (age 70+; T-score = -3.0 SD at lumbar spine, total hip, or femoral neck; prevalent vertebral fracture); (2) age 75+; and (3) intolerant or contraindicated to oral bisphosphonates (BPs). Analyses were conducted over a lifetime horizon comparing denosumab to usual care ('no therapy', alendronate, risedronate, or raloxifene [sub-group 3 only]). The analysis considered treatment-specific persistence and post-discontinuation residual efficacy, as well as treatment-specific adverse events. Both deterministic and probabilistic sensitivity analyses were conducted.
The multi-therapy comparisons resulted in incremental cost-effectiveness ratios for denosumab vs alendronate of $60,266 (2010 CDN$) (primary analysis) and $27,287 per quality-adjusted life year gained for scenario sub-group 1. Denosumab dominated all therapies in the remaining scenarios.
Key limitations include a lack of long-term, real-world, Canadian data on persistence with denosumab as well as an absence of head-to-head clinical data, leaving one to rely on meta-analyses based on trials comparing treatment to placebo.
Denosumab may be cost-effective compared to oral PMO treatments for women at high risk of fractures and those who are intolerant and/or contraindicated to oral BPs.
PubMed ID
23035625 View in PubMed
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Cost-effectiveness of Helicobacter pylori eradication for the long-term management of duodenal ulcer in Canada.

https://arctichealth.org/en/permalink/ahliterature214108
Source
Arch Intern Med. 1995 Oct 9;155(18):1958-64
Publication Type
Article
Date
Oct-9-1995
Author
B. O'Brien
R. Goeree
A H Mohamed
R. Hunt
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario.
Source
Arch Intern Med. 1995 Oct 9;155(18):1958-64
Date
Oct-9-1995
Language
English
Publication Type
Article
Keywords
Canada
Cost-Benefit Analysis
Decision Support Techniques
Duodenal Ulcer - economics - microbiology - therapy
Helicobacter Infections - economics - therapy
Helicobacter pylori
Humans
Models, Statistical
Recurrence
Time Factors
Abstract
A 1994 National Institutes of Health consensus panel recommended that eradication of Helicobacter pylori should be first-line therapy for persons with duodenal ulcer.
To assess the cost-effectiveness of H pylori eradication relative to alternative pharmacologic strategies in the long-term management of persons with confirmed duodenal ulcer.
Decision analysis model to estimate expected costs and symptomatic ulcer recurrences during a 12-month period for three general treatment strategies: (1) immediate H pylori eradication; (2) H pylori eradication at first ulcer recurrence; and (3) continuous maintenance therapy with a histamine2 receptor antagonist (ranitidine hydrochloride). Two H pylori eradication therapies were compared: classic triple therapy and omeprazole plus amoxicillin. Probabilities for ulcer recurrence are by meta-analysis of published randomized trials. Health care resources used in the management of duodenal ulcer recurrence were by expert physician panel. All costs are in 1993 Canadian dollars.
Duodenal ulcer recurrence at 6 months (symptomatic and asymptomatic) with placebo was 65.4% and 12.8% with maintenance ranitidine therapy. Where eradication of H pylori was successful (85% of patients), the ulcer recurrence rate to 12 months was 3.7%. Treatment with ranitidine and triple therapy to eradicate H pylori on first presentation has an expected 1-year cost of $253 with 15 symptomatic recurrences per 100 patients; H pylori eradication by omeprazole plus amoxicillin had similar expected costs ($272) and outcomes (15 recurrences per 100 patients). Both of these early H pylori eradication strategies were dominant (less costly with same or better outcomes) over intermittent or continuous maintenance ranitidine therapy or delayed (after first recurrence) H pylori eradication.
Our analysis provides economic evidence in support of the recent guidance that for persons with duodenal ulcer, early attempts to eradicate H pylori are recommended.
Notes
Comment In: Arch Intern Med. 1995 Oct 9;155(18):1929-317575045
Comment In: ACP J Club. 1996 Mar-Apr;124(2):53
PubMed ID
7575049 View in PubMed
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Cost-effectiveness of interventions for chronic obstructive pulmonary disease (COPD) using an Ontario policy model.

https://arctichealth.org/en/permalink/ahliterature119779
Source
Ont Health Technol Assess Ser. 2012;12(12):1-61
Publication Type
Article
Date
2012
Author
K. Chandra
G. Blackhouse
B R McCurdy
M. Bornstein
K. Campbell
V. Costa
J. Franek
K. Kaulback
L. Levin
S. Sehatzadeh
N. Sikich
M. Thabane
R. Goeree
Source
Ont Health Technol Assess Ser. 2012;12(12):1-61
Date
2012
Language
English
Publication Type
Article
Keywords
Cost-Benefit Analysis
Delivery of Health Care - economics
Health Policy - economics
Humans
Models, Statistical
Ontario
Pulmonary Disease, Chronic Obstructive - economics - therapy
Notes
Cites: Can Respir J. 2007 Mar;14(2):87-9217372635
Cites: Eur J Health Econ. 2007 Jun;8(2):123-3517370096
Cites: Respir Med. 2008 Mar;102(3):413-2118086519
Cites: Pharmacoeconomics. 2009;27(6):465-7719640010
Cites: Eur Respir J. 2010 Jan;35(1):79-8719574331
Cites: Arch Intern Med. 2010 Mar 22;170(6):560-520308643
Cites: Thorax. 2010 Aug;65(8):711-820685746
Cites: Int J Chron Obstruct Pulmon Dis. 2010;5:435-4421191438
Cites: Am J Respir Crit Care Med. 2001 Apr;163(5):1256-7611316667
Cites: BMJ. 2004 Jun 19;328(7454):149015205295
Cites: Am J Respir Crit Care Med. 1998 Mar;157(3 Pt 1):822-69517597
Cites: Ann Intern Med. 2005 Feb 15;142(4):233-915710956
Cites: Eur Respir J. 2005 May;25(5):891-515863648
Cites: Pharmacoeconomics. 2005;23(6):619-3715960557
Cites: COPD. 2006 Dec;3(4):219-3217361503
PubMed ID
23074422 View in PubMed
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Cost-effectiveness of screening swab or urine specimens for Chlamydia trachomatis from young Canadian women in Ontario.

https://arctichealth.org/en/permalink/ahliterature192393
Source
Sex Transm Dis. 2001 Dec;28(12):701-9
Publication Type
Article
Date
Dec-2001
Author
R. Goeree
D. Jang
G. Blackhouse
S. Chong
J. Mahony
J. Sellors
A. Foy
M. Chernesky
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Source
Sex Transm Dis. 2001 Dec;28(12):701-9
Date
Dec-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Chlamydia Infections - microbiology - prevention & control - urine
Chlamydia trachomatis - isolation & purification
Cost-Benefit Analysis
Decision Trees
Female
Humans
Mass Screening - economics - standards
Ontario
Pelvic Inflammatory Disease - microbiology - prevention & control - urine
Sensitivity and specificity
Urinalysis - economics - standards
Vaginal Smears - economics - standards
Women's health
Abstract
Undetected and untreated Chlamydia trachomatis infections can result in a significant health burden. Diagnostic testing refers to tests performed on patients with symptoms, whereas screening refers to testing specimens in asymptomatic patients. The goal of diagnostic testing and screening programs are early identification of infections to prevent upper tract infection and transmission to other partners.
To compare the costs and outcomes of alternative diagnostic testing and screening programs for women ages 15 to 24 years in the province of Ontario, Canada.
Using outcome probabilities from the literature and a consensus group, together with the costs from insurance billing, a decision analytic model was constructed to determine the baseline risk of C trachomatis and related sequelae. Seven diagnostic testing and screening programs were compared over a 10-year period. The programs compared included the use of nucleic acid amplification assays collected from urine or endocervical swab specimens.
Largely because of lower sensitivity the urine-based testing or screening programs were dominated by the swab-based programs. The move from swab-based testing to a swab-based screening program for high-risk women costs $1873 per case of C trachomatis averted. Expanding the program further to include all women in Ontario between 15 and 24 years of age is considerably more costly at $5990 per case averted.
It is more costly and more effective to screen and treat high-risk women ages 15 to 24 years for C trachomatis than to perform only swab-based diagnostic testing on symptomatic women. Expanding the screening program to include all women ages 15 to 24 years is considerably more expensive and only moderately more effective than screening only high-risk women.
PubMed ID
11725225 View in PubMed
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Cost-effectiveness of the carbon-13 urea breath test for the detection of Helicobacter pylori: an economic analysis.

https://arctichealth.org/en/permalink/ahliterature106169
Source
Ont Health Technol Assess Ser. 2013;13(20):1-28
Publication Type
Article
Date
2013
Author
L. Masucci
G. Blackhouse
R. Goeree
Source
Ont Health Technol Assess Ser. 2013;13(20):1-28
Date
2013
Language
English
Publication Type
Article
Keywords
Breath Tests - methods
Carbon Isotopes
Cost-Benefit Analysis
Diagnostic Errors - economics
Enzyme-Linked Immunosorbent Assay - economics - standards
Helicobacter Infections - diagnosis - economics
Helicobacter pylori - isolation & purification
Humans
Mass Screening - economics - standards
Ontario - epidemiology
Reproducibility of Results
Sensitivity and specificity
Urea - diagnostic use - economics
Abstract
This analysis aimed to evaluate the cost-effectiveness of various testing strategies for Helicobacter pylori in patients with uninvestigated dyspepsia and to calculate the budgetary impact of these tests for the province of Ontario.
Data on the sensitivity and specificity were obtained from the clinical evidence-based analysis. Resource items were obtained from expert opinion, and costs were applied on the basis of published sources as well as expert opinion.
A decision analytic model was constructed to compare the costs and outcomes (false-positive results, false-negative results, and misdiagnoses avoided) of the carbon-13 (¹³C) urea breath test (UBT), enzyme-linked immunosorbent assay (ELISA) serology test, and a 2-step strategy of an ELISA serology test and a confirmatory ¹³C UBT based on the sensitivity and specificity of the tests and prevalence estimates.
The 2-step strategy is more costly and more effective than the ELISA serology test and results in $210 per misdiagnosis case avoided. The ¹³C UBT is dominated by the 2-step strategy, i.e., it is more costly and less effective. The budget impact analysis indicates that it will cost $7.9 million more to test a volume of 129,307 patients with the ¹³C UBT than with ELISA serology, and $4.7 million more to test these patients with the 2-step strategy.
The clinical studies that were pooled varied in the technique used to perform the breath test and in reference standards used to make comparisons with the breath test. However, these parameters were varied in a sensitivity analysis. The economic model was designed to consider intermediate outcomes only (i.e., misdiagnosed cases) and was not a complete model with final patient outcomes (e.g., quality-adjusted life years).
Results indicate that the 2-step strategy could be economically attractive for the testing of H. pylori. However, testing with the 2-step strategy will cost the Ministry of Health and Long-Term Care $4.7 million more than with the ELISA serology test.
Notes
Cites: Br J Gen Pract. 2007 May;57(538):401-317504592
Cites: Clin Microbiol Rev. 2006 Jul;19(3):449-9016847081
Cites: Annu Rev Nutr. 1997;17:255-759240928
Cites: Can J Gastroenterol. 2004 Sep;18(9):547-5415457293
Cites: Aliment Pharmacol Ther. 2003 Jun 15;17(12):1481-9112823150
Cites: Am J Gastroenterol. 2000 Jul;95(7):1691-810925969
Cites: CMAJ. 2000 Jun 13;162(12 Suppl):S3-2310870511
Cites: BMC Health Serv Res. 2010;10:34421176158
PubMed ID
24228083 View in PubMed
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Cost-Effectiveness of tolterodine for patients with urge incontinence who discontinue initial therapy with oxybutynin: a Canadian perspective.

https://arctichealth.org/en/permalink/ahliterature191773
Source
Clin Ther. 2001 Dec;23(12):2038-49
Publication Type
Article
Date
Dec-2001
Author
B J O'Brien
R. Goeree
L. Bernard
A. Rosner
T. Williamson
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. obrienb@mcmaster.ca
Source
Clin Ther. 2001 Dec;23(12):2038-49
Date
Dec-2001
Language
English
Publication Type
Article
Keywords
Benzhydryl Compounds - economics - therapeutic use
Canada
Cost-Benefit Analysis
Cresols - economics - therapeutic use
Economics, Pharmaceutical
Humans
Mandelic Acids - economics - therapeutic use
Markov Chains
Muscarinic Antagonists - economics - therapeutic use
Parasympatholytics - economics - therapeutic use
Phenylpropanolamine
Quality-Adjusted Life Years
Randomized Controlled Trials as Topic
Severity of Illness Index
Urinary Incontinence - classification - drug therapy - economics
Abstract
Tolterodine is a novel muscarinic receptor antagonist for the treatment of overactive bladder.
The purpose of this study was to examine the cost-effectiveness of tolterodine for patients with urge incontinence (UI) who discontinue initial therapy with oxybutynin in a Canadian setting.
We compared 2 treatment strategies for the management of adult patients with UI: (1) generic oxybutynin with no further treatment for patients who discontinue and (2) generic oxybutynin with switch to tolterodine (2 mg BID) for patients who discontinue. We developed a 1-year Markov model (4-week cycle length) with transitions between disease states of normal, mild, moderate, and severe. Transition probabilities over 12 weeks were obtained from randomized trial data, and drug discontinuation rates were obtained from Quebec prescription claims data. Outcome measures were time in "normal" health state and quality-adjusted life-years (QALYs) using EuroQol-5D utility scores from a survey of Swedish patients with overactive bladder. Costs to the health care payer and patient out-of-pocket costs (in Canadian dollars) were included.
For patients who discontinue oxybutynin, the use of tolterodine is associated with approximately 6 months per year in a normal health or mild disease state, compared with approximately 3 months for those who do not receive further drug therapy after discontinuation. Tolterodine use resulted in an annual additional cost per patient of Can $163. The incremental cost per QALY was Can $9,982 and appeared to be robust to alternative model parameter assumptions.
Use of tolterodine in patients with UI who discontinue initial therapy with generic oxybutynin lies within currently accepted benchmarks for cost-effectiveness.
PubMed ID
11813937 View in PubMed
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The economic burden of schizophrenia in Canada.

https://arctichealth.org/en/permalink/ahliterature201668
Source
Can J Psychiatry. 1999 Jun;44(5):464-72
Publication Type
Article
Date
Jun-1999
Author
R. Goeree
B J O'Brien
P. Goering
G. Blackhouse
K. Agro
A. Rhodes
J. Watson
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario. goereer@fhs.csu.mcmaster.ca
Source
Can J Psychiatry. 1999 Jun;44(5):464-72
Date
Jun-1999
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada - epidemiology
Cost of Illness
Efficiency
Employment
Female
Humans
Male
Mental Health Services - economics
Middle Aged
Prevalence
Prisoners - statistics & numerical data
Schizophrenia - economics - epidemiology - therapy
Abstract
To estimate the financial burden of schizophrenia in Canada in 1996.
Using a prevalence-based approach, all direct health care costs, administrative costs of income assistance plans, and costs of incarceration attributable to schizophrenia were determined. Also included was the value of lost productivity associated with premature mortality and morbidity. In addition to using published papers and documents, direct contact was made with representatives from various provincial and federal programs for estimates of the direct health care and non-health care costs.
The estimated number of persons with schizophrenia in Canada in 1996 was 221,000, with equal distribution between males and females. The direct health care and non-health care cost was estimated to be $1.12 billion in 1996. In addition, another $1.23 billion in lost productivity associated with morbidity and premature mortality was attributable to schizophrenia.
The total financial burden of schizophrenia in Canada was estimated to be $2.35 billion in 1996. The largest category of cost was morbidity (52%), followed by acute care and psychiatric hospital admissions (14% and 10% respectively). Given the magnitude of these cost estimates, there are large potential cost savings with more effective management and control of this debilitating disease.
PubMed ID
10389607 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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24 records – page 1 of 3.