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The economic burden associated with MEs and especially SEs, in Canada, is considerable and likely has a substantial impact on healthcare costs. The overall burden of exacerbations has been estimated in the range of $646 million to $736 million per annum.

This study provides health economists, researchers and policy-makers with a reference for health utilities of various chronic conditions, different age groups, gender and comorbidities.

Background A significant share of the cost of cancer care is concentrated in the end-of-life period. Although quality measures of aggressive treatment may guide optimal care during this timeframe, little is known as to whether these metrics affect costs of care. Methods We used population data to identify a cohort of patients who died of cancer in Ontario, Canada (2005 to 2009). Individuals were categorized as having received aggressive end-of-life care or not, according to quality measures related to acute institutional care or chemotherapy administration in the end-of-life period. Costs (2009 $CAN) were collected over the last month of life by linking health system administrative databases. Multivariable quantile regression was used to identify predictors of increased costs. Results Among 107,253 patients, the mean per patient cost over the final month was $18,131 for patients receiving aggressive care and $12,678 for patients receiving non-aggressive care (p<0.0001). Patients who received chemotherapy in the last 2 weeks of life also sustained higher costs compared to those who did not (p<0.0001). For individuals receiving end-of-life care in the highest cost quintile, early and repeated palliative care consultation was associated with reduced mean per patient costs. On multivariable analysis, chemotherapy in the 2 weeks of life remained predictive of increased costs (median increase $536; p<0.0001) whereas access to palliation remained predictive for lower costs (median decrease $418; p<0.0001). Conclusions Cancer patients who receive aggressive end-of-life care incur 43% higher costs than those managed non-aggressively. Palliative consultation may partially offset these costs and offer resultant savings.

The incremental cost-effectiveness ratio of cetuximab over best supportive care alone in unselected advanced colorectal cancer patients is high and sensitive to drug cost. Incremental cost-effectiveness ratios were lower when the analysis was limited to patients with wild-type KRAS tumors.

Journal of Clinical Epidemiology; none were involved with the peer review of this article or decision to publish. B.H. previously received honoraria from Eversana for provision of methodologic advice related to the conduct of systematic reviews. J.M. is a co-convenor of the Cochrane Information Retrieval Methods Group. C.M.G. is the co-convenor of the Cochrane Rapid Reviews Methods Group and provides consultancy to Cochrane Response. S.L. is the Joint Coordinating Editor of Cochrane Effective Practice and Organisation of Care (EPOC) and Chair of the Governance Group of the Global Evidence Synthesis Initiative (GESI).

Background: Longitudinal, patient-level data on resource use and costs after an ischemic stroke are lacking in Canada. The objectives of this analysis were to calculate costs for the first year post-stroke and determine the impact of disability on costs. Methodology: The Economic Burden of Ischemic Stroke (BURST) Study was a one-year prospective study with a cohort of ischemic stroke patients recruited at 12 Canadian stroke centres. Clinical history, disability, health preference and resource utilization information was collected at discharge, three months, six months and one year. Resources included direct medical costs (2009 CAN$) such as emergency services, hospitalizations, rehabilitation, physician services, diagnostics, medications, allied health professional services, homecare, medical/assistive devices, changes to residence and paid caregivers, as well as indirect costs. Results were stratified by disability measured at discharge using the modified Rankin Score (mRS): nondisabling stroke (mRS 0-2) and disabling stroke (mRS 3-5). Results: We enrolled 232 ischemic stroke patients (age 69.4 ± 15.4 years; 51.3% male) and 113 (48.7%) were disabled at hospital discharge. The average annual cost was $74,353; $107,883 for disabling strokes and $48,339 for non-disabling strokes. Conclusions: An average annual cost for ischemic stroke was calculated in which a disabling stroke was associated with a two-fold increase in costs compared to NDS. Costs during the hospitalization to three months phase were the highest contributor to the annual cost. A "back of the envelope" calculation using 38,000 stroke admissions and the average annual cost yields $2.8 billion as the burden of ischemic stroke.RÉSUMÉ: Impact du degré d'invalidité sur les coûts reliés à l'accident vasculaire cérébral ischémique au cours de la première année au Canada. Contexte : Nous n'avons pas de données longitudinales sur l'utilisation des ressources par les patients et les coûts ainsi engendrés suite à un accident vasculaire cérébral (AVC) ischémique au Canada. Les buts de cette analyse étaient de calculer les coûts engendrés au cours de la première année après un AVC et de déterminer l'impact de l'invalidité sur ces coûts. Méthode : Le Economic Burden of Ischemic Stroke (BURST) Study est une étude prospective d'une durée de un an chez une cohorte de patients ayant subi un AVC ischémique qui ont été recrutés dans 12 centres canadiens de traitement de l'AVC. Des informations ont été recueillies sur l'histoire clinique, l'invalidité, les choix de santé et l'utilisation des ressources au moment du congé hospitalier, trois mois, six mois et un an plus tard. Les ressources incluaient les coûts médicaux directs (en $ canadiens 2009) comme les services d'urgence, les hospitalisations, la réadaptation, les frais médicaux, diagnostiques et thérapeutiques, les autres services professionnels, les soins à domicile, les équipements médicaux/accessoires fonctionnels, les changements effectués au lieu de résidence et les aidants rémunérés ainsi que les ...