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Impact of 10 years of glaucoma research funding: the Glaucoma Research Society of Canada.

https://arctichealth.org/en/permalink/ahliterature144333
Source
Can J Ophthalmol. 2010 Apr;45(2):132-4
Publication Type
Article
Date
Apr-2010
Author
Gamal Seif
Graham Trope
Author Affiliation
Department of Ophthalmology, McMaster University, Hamilton, Ont.
Source
Can J Ophthalmol. 2010 Apr;45(2):132-4
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Biomedical Research - economics
Canada
Case-Control Studies
Cost-Benefit Analysis
Financing, Government
Glaucoma
Health Services Research
Humans
Peer Review, Research
Program Evaluation
Research Support as Topic
Societies, Medical
Abstract
The purpose of this study was to assess the efficacy of grants from the Glaucoma Research Society of Canada (GRSC) in achieving the society's stated goals (i.e., advancing the scientific community's knowledge of the causes, diagnosis, prevention, and treatment of glaucoma).
Case-control study.
Twenty-seven glaucoma researchers who received grants from the GRSC.
The number of peer-reviewed journal publications that arose from studies funded by the GRSC was obtained through grant recipient surveys, searching for GRSC acknowledgement within the literature, and comparing all articles published by each grant recipient with the subject matter of his or her successful grant proposals.
A total of 73 research grant applications valued at $680,900 were funded by the GRSC between 1997 and 2006, 48 of which (66%) resulted in at least one publication, for a total of 70 articles. This represented a cost of donor dollars per publication of $9727.
Sixty-six percent of GRSC grants generated new knowledge in the form of peer-reviewed publications.
Notes
Comment In: Can J Ophthalmol. 2010 Apr;45(2):113-420379291
PubMed ID
20379296 View in PubMed
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Assessing payback from research investment.

https://arctichealth.org/en/permalink/ahliterature144336
Source
Can J Ophthalmol. 2010 Apr;45(2):113-4
Publication Type
Article
Date
Apr-2010
Author
Yvonne M Buys
Source
Can J Ophthalmol. 2010 Apr;45(2):113-4
Date
Apr-2010
Language
English
French
Publication Type
Article
Keywords
Biomedical Research - economics
Canada
Cost-Benefit Analysis
Financing, Government - statistics & numerical data
Health Services Research - economics
Humans
Program Evaluation
Research Support as Topic
Notes
Comment On: Can J Ophthalmol. 2010 Apr;45(2):132-420379296
PubMed ID
20379291 View in PubMed
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The cost of starting and maintaining a large home hemodialysis program.

https://arctichealth.org/en/permalink/ahliterature144364
Source
Kidney Int. 2010 Jun;77(11):1039-45
Publication Type
Article
Date
Jun-2010
Author
Paul Komenda
Michael Copland
Jay Makwana
Ogdjenka Djurdjev
Manish M Sood
Adeera Levin
Author Affiliation
British Columbia Provincial Renal Agency, Vancouver, Canada. paulkomenda@yahoo.com
Source
Kidney Int. 2010 Jun;77(11):1039-45
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
British Columbia
Cost-Benefit Analysis
Drug Costs
Health Care Costs
Health Personnel - economics
Hemodialysis Units, Hospital - economics
Hemodialysis, Home - adverse effects - economics - mortality
Hospitalization - economics
Humans
Kidney Failure, Chronic - economics - mortality - therapy
Models, Economic
Patient Education as Topic - economics
Personnel Staffing and Scheduling - economics
Program Development
Retrospective Studies
Time Factors
Abstract
Home extended hours hemodialysis improves some measurable biological and quality-of-life parameters over conventional renal replacement therapies in patients with end-stage renal disease. Published small studies evaluating costs have shown savings in terms of ongoing operating costs with this modality. However, all estimates need to include the total costs, including infrastructure, patient training, and maintenance; patient attrition by death, transplantation, technique failure; and the necessity of in-center dialysis. We describe a comprehensive funding model for a large centrally administered but locally delivered home hemodialysis program in British Columbia, Canada that covered 122 patients, of which 113 were still in the program at study end. The majority of patients performed home nocturnal hemodialysis in this 2-year retrospective study. All training periods, both in-center and in-home dialysis, medications, hospitalizations, and deaths were captured using our provincial renal database and vital statistics. Comparative data from the provincial database and pricing models were used for costing purposes. The total comprehensive costs per patient-incorporating startup, home, and in-center dialysis; medications; home remodeling; and consumables-was $59,179 for years 2004-2005 and $48,648 for 2005-2006. The home dialysis patients required multiple in-center dialysis runs, significantly contributing to the overall costs. Our study describes a valid, comprehensive funding model delineating reliable cost estimates of starting and maintaining a large home-based hemodialysis program. Consideration of hidden costs is important for administrators and planners to take into account when designing budgets for home hemodialysis.
Notes
Comment In: Kidney Int. 2010 Oct;78(8):819; author reply 819-2020877379
PubMed ID
20375983 View in PubMed
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Treatment evolution and new standards of care: implications for cost-effectiveness analysis.

https://arctichealth.org/en/permalink/ahliterature144568
Source
Med Decis Making. 2011 Jan-Feb;31(1):35-42
Publication Type
Article
Author
Steven M Shechter
Author Affiliation
Sauder School of Business, University of British Columbia, Vancouver, BC, Canada. steven.shechter@sauder.ubc.ca
Source
Med Decis Making. 2011 Jan-Feb;31(1):35-42
Language
English
Publication Type
Article
Keywords
British Columbia
Cost-Benefit Analysis
Humans
Markov Chains
Models, Statistical
Patient Care - economics - standards
Probability
Quality-Adjusted Life Years
Abstract
Traditional approaches to cost-effectiveness analysis have not considered the downstream possibility of a new standard of care coming out of the research and development pipeline. However, the treatment landscape for patients may change significantly over the course of their lifetimes.
To present a Markov modeling framework that incorporates the possibility of treatment evolution into the incremental cost-effectiveness ratio (ICER) that compares treatments available at the present time.
. Markov model evaluated by matrix algebra. Measurements. The author evaluates the difference between the new and traditional ICER calculations for patients with chronic diseases facing a lifetime of treatment.
The bias of the traditional ICER calculation may be substantial, with further testing revealing that it may be either positive or negative depending on the model parameters. The author also performs probabilistic sensitivity analyses with respect to the possible timing of a new treatment discovery and notes the increase in the magnitude of the bias when the new treatment is likely to appear sooner rather than later. Limitations. The modeling framework is intended as a proof of concept and therefore makes simplifying assumptions such as time stationarity of model parameters and consideration of a single new drug discovery.
For diseases with a more active research and development pipeline, the possibility of a new treatment paradigm may be at least as important to consider in sensitivity analysis as other parameters that are often considered.
PubMed ID
20354228 View in PubMed
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Cost-effectiveness of switching to biphasic insulin aspart from human premix insulin in a US setting.

https://arctichealth.org/en/permalink/ahliterature144608
Source
J Med Econ. 2010;13(2):212-20
Publication Type
Article
Date
2010
Author
James L Palmer
Martin S Knudsen
Mark Aagren
Trine L Thomsen
Author Affiliation
IMS Health, COREâ??Center for Outcomes Research GmbH, Gewerbestrasse 25, Allschwil, Switzerland. jpalmer@ch.imshealth.com
Source
J Med Econ. 2010;13(2):212-20
Date
2010
Language
English
Publication Type
Article
Keywords
Biphasic Insulins
Body mass index
Canada
Cost-Benefit Analysis
Diabetes Mellitus, Type 2 - complications - drug therapy - economics
Female
Hemoglobin A, Glycosylated
Humans
Hypoglycemic Agents - economics - therapeutic use
Insulin - analogs & derivatives - economics - therapeutic use
Insulin Aspart
Insulin, Isophane
Male
Middle Aged
Monte Carlo Method
Patient satisfaction
Quality of Life
Quality-Adjusted Life Years
Risk factors
United States
Abstract
To evaluate the cost-effectiveness of switching to biphasic insulin aspart (BIAsp 30) from human premix insulin for type 2 diabetes patients in the United States (US) setting.
The previously published and validated IMS Core Diabetes Model was used to project life expectancy, quality-adjusted life expectancy (QALE) and costs over 30 years. Patient characteristics and treatment effects were based on Canadian patients included the IMPROVE observational study (n = 311). Mean glycohaemoglobin (HbA(1c)) was 8.4%, duration of diabetes 16 years and prevalence of complications high at baseline. Simulations were conducted from the perspective of a third-party payer, with costs accounted in 2008 US dollars ($).
BIAsp 30 was projected to improve life expectancy by 0.202 years and QALE by 0.301 quality-adjusted life-years (QALYs), due to a reduced incidence of most diabetes-related complications. BIAsp 30 was associated with increased lifetime direct medical costs ($76,517 vs. 67,518) and an incremental cost-effectiveness ratio of $29,870 per QALY gained. Long-term outcomes were sensitive to the impact of BIAsp 30 on hypoglycaemia and changes in HbA(1c).
BIAsp 30 may represent a cost-effective treatment option in the US setting for advanced type 2 diabetes patients experiencing poor glycaemic control or hypoglycaemia on human premix insulin.
The application of treatment effect data derived from a Canadian cohort to the US setting was a limitation of the cost-effectiveness analysis. The findings of this cost-effectiveness analysis are not applicable to insulin-naïve diabetes patients.
PubMed ID
20350145 View in PubMed
Less detail
Source
Oncologist. 2010;15 Suppl 1:24-31
Publication Type
Article
Date
2010
Author
Patricia M Danzon
Erin Taylor
Author Affiliation
University of Pennsylvania, Philadelphia, 19104, USA. danzon@wharton.upenn.edu
Source
Oncologist. 2010;15 Suppl 1:24-31
Date
2010
Language
English
Publication Type
Article
Keywords
Antineoplastic Agents - economics
Canada
Cost-Benefit Analysis
Drug Costs
Drug Industry
Drug Prescriptions
Humans
Insurance Coverage
Medicare - economics
Neoplasms - drug therapy - economics
Reimbursement Mechanisms
United States
Abstract
This paper examines the issue of prices, relative to value, for cancer drugs. The analysis focuses on the effects on manufacturer pricing incentives of insurance coverage, specifically, the effectiveness of patient cost sharing, incentives created by reimbursement rules for physician-dispensed drugs, and payer ability and incentives to negotiate discounts. For pharmacy-dispensed cancer drugs, both Medicare Part D prescription drug plans (PDPs) and private payers' pharmacy benefit managers are increasingly placing these drugs on specialty tiers that offer no leverage for negotiating discounts and imply often unaffordable cost sharing for patients who lack catastrophic coverage. Simulation analysis of financial risks faced by PDPs confirms their incentives to place costly drugs on specialty tiers if more preferred formulary placement would increase use, possibly because of adverse selection risk. Faced with largely price-insensitive consumers and payers, manufacturers would rationally charge high prices. This situation is exacerbated for physician-dispensed cancer drugs, where Medicare's average selling price plus 6% reimbursement rule favors high-priced drugs. Because U.S. payers do not require evidence on prices relative to value, U.S. data are unavailable to test whether prices are higher, relative to value, for cancer drugs than for other drugs. Evidence from the Canadian Common Drug Review on cost-utility values suggests that cancer drugs are relatively high priced, although conclusions are tentative because of very small samples and non-U.S. data. Making such outcomes-adjusted prices available in the U.S. would be helpful to physicians, payers, and patients and indirectly constrain pricing to align with value.
PubMed ID
20237214 View in PubMed
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Attitudes of Canadian dairy farmers toward a voluntary Johne's disease control program.

https://arctichealth.org/en/permalink/ahliterature144651
Source
J Dairy Sci. 2010 Apr;93(4):1491-9
Publication Type
Article
Date
Apr-2010
Author
U. Sorge
D. Kelton
K. Lissemore
A. Godkin
S. Hendrick
S. Wells
Author Affiliation
Department of Population Medicine, University of Guelph, Guelph N1G 2W1, Ontario, Canada. usorge@uoguelph.ca
Source
J Dairy Sci. 2010 Apr;93(4):1491-9
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Animal Husbandry - economics - methods - standards
Animals
Attitude to Health
Canada
Cattle
Cattle Diseases - prevention & control
Cost-Benefit Analysis
Dairying - economics - manpower - methods - standards
Euthanasia, Animal
Female
Health status
Humans
Paratuberculosis - prevention & control
Risk assessment
Abstract
The success of Johne's disease (JD) control programs based on risk assessment (RA) depends on producers' compliance with suggested management practices. One objective of this study was to describe the perception of participating Canadian dairy farmers of the impact of JD, the RA process, and suggested management strategies. The second objective was to describe the cost of changes in management practices following the RA. A telephone survey was conducted with 238 dairy farmers in Ontario, Manitoba, Saskatchewan, Alberta, and British Columbia. The producers agreed to participate in this follow-up study after they had been enrolled in an RA-based voluntary JD control program and had tested their herd with the JD milk ELISA test in 2005 to 2007. The majority of farms had no JD test-positive cows and, although some producers thought they had experienced the economic impact of JD, many did not see JD as a current problem for their herd. The majority of producers enrolled in this program because they were concerned that Mycobacterium avium ssp. paratuberculosis could be perceived by consumers as a cause for Crohn's disease in humans, which could lead to altered purchasing behavior of milk and milk products. Fifty-two farm-specific recommendations had been made after the initial RA. Although the producers generally liked the program and found the recommendations reasonable and feasible, on average only 2 of 6 suggestions made specifically to them were implemented. The recommendation with the highest compliance was culling of JD test-positive cows. The main reasons for noncompliance were that the dairy producer did not believe a change of management practices was necessary or the available barn setting or space did not allow the change. Producers were generally uncomfortable estimating time and monetary expenses for management changes, but found that several suggested management practices actually saved time and money. In addition, 39% of the producers that implemented at least 1 recommendation thought their calf and herd health had improved subsequently. This indicates that the communication of associated benefits needs to be improved to increase the compliance of producers with recommended management practices.
PubMed ID
20338426 View in PubMed
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Experience with physician assistants in a Canadian arthroplasty program.

https://arctichealth.org/en/permalink/ahliterature144679
Source
Can J Surg. 2010 Apr;53(2):103-8
Publication Type
Article
Date
Apr-2010
Author
Eric R Bohm
Michael Dunbar
David Pitman
Chris Rhule
Jose Araneta
Author Affiliation
The Division of Orthopedic Surgery, University of Manitoba, Winnipeg, MB. ebohm@cjrg.ca
Source
Can J Surg. 2010 Apr;53(2):103-8
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Arthroplasty
Attitude of Health Personnel
Canada
Cost-Benefit Analysis
Humans
Internship and Residency
Models, organizational
Nursing Staff, Hospital
Operating Rooms
Orthopedics - manpower
Patient satisfaction
Physician Assistants - economics
Physicians, Family
Quality of Health Care
Questionnaires
Surgery Department, Hospital
Time Management
Waiting Lists
Workload - statistics & numerical data
Abstract
Recent increases in orthopedic surgical services in Canada have added further demand to an already stretched orthopedic workforce. Various initiatives have been undertaken across Canada to meet this demand. One successful model has been the use of physician assistants (PAs) within the Winnipeg Regional Health Authority (WRHA). This study documents the effect of PAs working in an arthroplasty practice from the perspective of patients and health care providers. We also describe the costs, time savings for surgeons and the effects on surgical throughput and waiting times.
We calculated time savings by the use of a daily diary kept by the PAs. Surgeons', residents', nurses' and patients' opinions about PAs were recorded by use of a self administered questionnaire. We calculated costs using forgone general practitioner (GP) surgical assist fees and salary costs for PAs. We obtained information about surgical throughput and wait times from the WRHA waitlist database.
In this study, PAs "saved" their supervising physician about 204 hours per year; this time can be used for other clinical, administrative or research duties. Physician assistants are regarded as important members of the health care team by surgeons, nurses, orthopedic residents and patients. When we compared the billing costs with those that would have been generated by the use of GP surgical assists, PAs were essentially cost neutral. Furthermore, they potentially freed GPs from the operating room to spend more time delivering primary care. We found that use of the double operating room model facilitated by PAs increased the surgical throughput of primary hip and knee replacements by 42%, and median wait times decreased from 44 weeks to 30 weeks compared with the preceding year.
Physician assistants integrate well into the care team and can increase surgical volumes to reduce wait times in a cost-effective manner.
Notes
Cites: Acta Orthop Scand. 2000 Jun;71(3):262-710919297
Cites: Healthc Q. 2008;11(2):67-7518362523
Cites: J Arthroplasty. 1997 Jun;12(4):387-969195314
Cites: Med Care Rev. 1993 Summer;50(2):219-4810127084
PubMed ID
20334742 View in PubMed
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Current and predicted cost of metastatic renal cell carcinoma in Finland.

https://arctichealth.org/en/permalink/ahliterature144706
Source
Acta Oncol. 2010 Aug;49(6):837-43
Publication Type
Article
Date
Aug-2010
Author
Timo Purmonen
Päivi Nuttunen
Riikka Vuorinen
Seppo Pyrhönen
Vesa Kataja
Pirkko Kellokumpu-Lehtinen
Author Affiliation
Department of Social Pharmacy, Centre for Pharmaceutical Policy and Economics, University of Kuopio, Kuopio, Finland. Timo.Purmonen@uef.fi
Source
Acta Oncol. 2010 Aug;49(6):837-43
Date
Aug-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - economics - therapeutic use
Carcinoma, Renal Cell - drug therapy - economics - mortality - secondary
Confidence Intervals
Cost of Illness
Cost-Benefit Analysis
Drug Costs
Female
Finland
Health Care Costs
Humans
Indoles - administration & dosage - economics
Interferon-alpha - administration & dosage - economics
Interleukin-2 - administration & dosage - economics
Kaplan-Meier Estimate
Kidney Neoplasms - drug therapy - economics - mortality - pathology
Male
Middle Aged
Odds Ratio
Pyrroles - administration & dosage - economics
Treatment Outcome
Abstract
Information on detailed treatment costs and the economic burden of renal cell carcinoma (RCC) is rare. The current study provides treatment costs and outcomes of patients with metastatic RCC (mRCC), as well as estimates of the future burden from the perspective of Finnish health care. These results offer a baseline against which the impact of emerging treatments may be evaluated.
Information on treatment modalities, survival, and the cost of treatment was retrospectively gathered from mRCC patients (n = 83) receiving first-line interferon-alpha (IFN). Predictions of the number of new cases, premature deaths, and productivity losses were made using local epidemiological data, which were projected to the future using population growth forecasts. The future costs of mRCC treatment and the budget impact of sunitinib were estimated through modeling.
Patients survived 11.9 months (median; 95% CI 9.2-14.7) after initiation of active IFN treatment, accruing an average total treatment cost of 951 euros. Most of the treatment costs were due to hospitalization and active IFN treatment. The aging of the population leads to nearly a 2% increase in the absolute number of new diagnoses annually, while at the same time it results in declining productivity losses. The estimated five-year population cost of IFN-based treatment was 16M euros-26M euros. Adding sunitinib to the first-line treatment protocol increased this cost by 13M eruos-41M euros.
Despite the limited number of patients, metastatic renal cell carcinoma places a considerable economic burden on Finnish society. Treatment costs are likely to increase substantially due to the adoption of new and more expensive medications, the aging population, and enhanced survival times.
PubMed ID
20331406 View in PubMed
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Workplace involvement improves return to work rates among employees with back pain on long-term sick leave: a systematic review of the effectiveness and cost-effectiveness of interventions.

https://arctichealth.org/en/permalink/ahliterature145051
Source
Disabil Rehabil. 2010;32(8):607-21
Publication Type
Article
Date
2010
Author
Christopher Carroll
Jo Rick
Hazel Pilgrim
Jackie Cameron
Jim Hillage
Author Affiliation
University of Sheffield, Sheffield, S1 4DA, UK. c.carroll@shef.ac.uk
Source
Disabil Rehabil. 2010;32(8):607-21
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Back Pain - rehabilitation
Canada
Cost-Benefit Analysis
Europe
Human Engineering
Humans
Occupational Diseases - rehabilitation
Sick Leave
Workplace
Abstract
Long-term sickness absence among workers is a major problem in industrialised countries. The aim of the review is to determine whether interventions involving the workplace are more effective and cost-effective at helping employees on sick leave return to work than those that do not involve the workplace at all.
A systematic review of controlled intervention studies and economic evaluations. Sixteen electronic databases and grey literature sources were searched, and reference and citation tracking was performed on included publications. A narrative synthesis was performed.
Ten articles were found reporting nine trials from Europe and Canada, and four articles were found evaluating the cost-effectiveness of interventions. The population in eight trials suffered from back pain and related musculoskeletal conditions. Interventions involving employees, health practitioners and employers working together, to implement work modifications for the absentee, were more consistently effective than other interventions. Early intervention was also found to be effective. The majority of trials were of good or moderate quality. Economic evaluations indicated that interventions with a workplace component are likely to be more cost effective than those without.
Stakeholder participation and work modification are more effective and cost effective at returning to work adults with musculoskeletal conditions than other workplace-linked interventions, including exercise.
PubMed ID
20205573 View in PubMed
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2787 records – page 1 of 279.