Rob Hopkins

The burden of illness of osteoporosis in Canada.

SummaryTo update the 1993 burden of illness of osteoporosis in Canada, administrative and community data were used to calculate the 2010 costs of osteoporosis at

Estimation of the lifetime risk of hip fracture for women and men in Canada

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.IntroductionSince 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.MethodsAnalyses 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.ResultsOsteoporosis-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

Estimating the excess costs for patients with incident fractures, prevalent fractures, and nonfracture osteoporosis

1.2 billion. When outpatient care, prescription drugs, and indirect costs were added, the overall yearly cost of osteoporosis was over

Prevalence, Total and Excess Costs of Diabetes and Related Complications in Ontario, Canada

2.3 billion for the base case analysis and as much as

Canadian cost-utility analysis of initiation and maintenance treatment with anti-TNF-α drugs for refractory Crohn's disease

3.9 billion if a proportion of Canadians were assumed to be living in long-term care facilities due to osteoporosis.ConclusionsOsteoporosis is a chronic disease that affects a large segment of the adult population and results in a substantial economic burden to the Canadian society.

The efficacy and short-term effects of electronic cigarettes as a method for smoking cessation: a systematic review and a meta-analysis

SummaryIn Canada in 2008, based on current rates of fracture and mortality, a woman or man at age 50xa0years 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.IntroductionIn 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.MethodsWe 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 50xa0years 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.ResultsFrom 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%).ConclusionsThe 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

Cost-Utility of Laparoscopic Nissen Fundoplication versus Proton Pump Inhibitors for Chronic and Controlled Gastroesophageal Reflux Disease: A 3-Year Prospective Randomized Controlled Trial and Economic Evaluation

SummaryBased 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.IntroductionCost 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.MethodsMen 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.ResultsSeventy-three percent of provincial population age 50+ (52xa0% of all men and 91xa0% 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

The current economic burden of illness of osteoporosis in Canada

44,963 (95xa0% CI:

Economic evaluation of drug-eluting stents compared to bare metal stents using a large prospective study in Ontario

38,498–51,428) and women

Surrogate outcomes: experiences at the Common Drug Review

45,715 (95xa0% CI: