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The economics of canadian health care

1. Read the following article:

Kim, D. D. et al. (2020). Perspective and Costing in Cost-Effectiveness Analysis, 1974-2018. PharmacoEconomics, 38, 1135-1145. Retrieved from https://doi.org/10.1007/s40273-020-00942-2

1.a

a. Write a 3-2-1 report in the usual fashion. (12 marks)

1.b

b. Read the following (extremely short) article:

Primeau, C. A., Marsh, J. D., Birmingham, T. B. & Giffin, J. R. (2019). The importance of costing perspective: an example evaluating the cost-effectiveness of a locking versus non-locking plate in medial opening wedge high tibial osteotomy. Canadian Journal of Surgery, 62(1), E14-E16. Retrieved from http://canjsurg.ca/62-1-e14/

Note that you’ll need to click the ‘PDF’ link at the top to read the full article. If you’d like an HTML version, see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351264/

The authors claim that in addition to the usual “health care payer perspective,” they take a “societal perspective”. In the Appendix[1] to their paper, they clarify what this means. Briefly, in their “societal” perspective they included:

· Direct costs to the provincial single payer, using a case costing approach

· All additional related costs to the provincial single payer over the year after the surgery, using a case costing approach.

· “[E]mployment time lost, and homemaking or volunteer time lost” during the study period (surgery + 12 months later). This was obtained either via patient interviews, or analysis of reports of follow-up visits.

· “The 2015 average Canadian wage reported by Statistics Canada was used to value time off employment. We assigned the current value of minimum wage in Ontario to account for time off for patients who were retried, or who lost time from home making or volunteer activities.”

i. (3 marks) The Kim et al. paper has very specific ideas about what a Societal (or Limited Societal) perspective is. Do you think that Kim et al. would agree that the Primeau et al. paper included an analysis from a Societal (or Limited Societal) perspective? Why or why not?

Is the (Primeau, 2019) ‘Societal’ perspective a (Kim et al., 2020) ‘Societal’ or ‘Limited Societal’ perspective? (Yes/No/Maybe)

Why or why not?

ii. (3 marks) Using what you have learned in ECON 317, in your economics degree so far, and from the Kim et al. paper, make a suggestion for how to improve the ‘Societal perspective’ in the (Primeau, 2019) paper. Briefly explain why your suggestion would be helpful.

Suggestion:

Why it’s helpful:

[1] Click on ‘Appendix’ next to the PDF link on the canjsurg page, or use this link: http://canjsurg.ca/wp-content/uploads/2019/01/018317-a1.pdf