Economic Burden of Illness in Canada (EBIC) 2014 Report by PHAC for 2005 – 2008 CPHA 2014 Conference Presentation Joe Devlin, Senior Health Economist Public

Economic Burden of Illness in Canada (EBIC)2014 Report by PHAC for 2005 – 2008

CPHA 2014 Conference Presentation

Joe Devlin, Senior Health Economist

Public Health Agency of Canada

The Economic Burden of Illness Canada (EBIC) Report

• Comprehensive cost-of-illness (COI) and injury study based on standard reporting units and methods

• Provides stakeholders with objective and comparable information on the magnitude of the economic burden of illness and injury in Canada

• EBIC reports are available for select years:» Past EBIC estimates published for 1986, 1993 and 1998» 2000 EBIC estimates available, however not published» EBIC 2005 – 2008 targeting a June 2014 release date

Economic Burden of Illness in Canada, 2005-2008

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What will EBIC 2005-2008 include?

• Comparable cost totals including information on:» Diagnostic category, sex, and age group» Direct costs (hospital care, physician care, and drugs) » Indirect costs (value of lost production due to morbidity

and premature mortality)

• Costs estimates attributable to 165 unique diagnostic subcategories based on most responsible diagnosis» No comorbidity or provincial-level cost estimates» Cost estimates by ICD code for special requests

• EBIC Online Tool: developed to increase accessibility for stakeholders and facilitate future data releases


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EBIC Direct Cost Components

• Hospital care» 2005-2008 estimates attributed to the most responsible health condition for all

hospital types (e.g. general, psychiatric, chronic and rehabilitation)» Data sourced from the Canadian Institute for Health Information (CIHI)

• Physician care » 2005-2008 estimates based on publically available Manitoba cost totals rather

than P/T record-level physician billing data» Manitoba cost totals available by sex and ICD chapter; estimates for other P/Ts

derived by per capita method» To obtain ICD code-level cost estimates, EBIC 2000 cost distributions (by P/T,

age group and sex) were used

• Drugs » 2005-2008 estimates based on linked data from retail pharmacies and diagnostic

information from a physician survey » Data sourced from IMS Brogan


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EBIC Indirect Cost Components

• Value of lost production due to morbidity and mortality:» Provincial unemployment duration used to denote the ‘friction

period’ (time to replace a sick or deceased worker)» Sex, age group and province-specific earnings used to value lost

production

• Change in methodology for measuring lost production costs» EBIC 2005-2008 uses the friction cost method (FCM) not the human

capital method (HCM) used in previous EBIC reports» Based on recommendations by national and international experts

who attended the 2009 and 2010 EBIC workshops hosted by PHAC

• Adopting the FCM leads to lower indirect cost estimates» EBIC 1998 indirect cost estimates were ~47% of total» EBIC 2005-2008 indirect cost estimates were ~10%


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Period of lost production using HCM

A= Point individual becomes unable to work due to illness/injuryB= Point individual would reach retirement age or life expectancyC= Point where job vacancy is filled (end of the friction period)

B

Yt-1 Yt Yt+10

A period of lost production

Period of lost production using FCM

Yt-1 Yt Yt+10

A Bperiod of lost productionC

Cost Estimates by Cost Type and Cost Component, Canada, 2005-2008 ($’000,000 2010 Constant Dollars)

Year

Direct Costs Indirect Costs Total Costs

Hospital Care Drug Physician

Care Unattributable Subtotal Mortality Morbidity Unattributable Subtotal All

2005 33,831 19,297 12,259 87,836 153,224 470 9,766 6,318 16,230 169,454

2006 35,936 19,991 12,996 92,147 161,069 471 9,931 6,196 16,499 177,568

2007 38,224 20,952 13,050 95,204 167,430 462 10,117 6,097 16,774 184,205

2008 39,745 21,633 13,766 100,479 175,623 464 10,423 5,994 17,205 192,828


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Cost Distribution by Cost Component for the Five Diagnostic Categories with the Highest Total Costs, Canada, 2008


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Cost Distribution by Sex and Cost Component, Canada, 2008


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Cost Distribution by Age Group and Cost Component, Canada, 2008


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EBIC – Beyond 2008?

PHAC is considering several next steps:

»Allocate more of the “unattributable” costs»Attribute costs to multiple diagnoses (comorbidities)»Provide provincial-level results (confidentiality constraints)»Estimate the economic burden of informal caregiving»Estimate the time spent seeking medical care»Include intangible costs (e.g. pain and suffering) »Examine the relationship between costs and illness burden»Implement a more regular release cycle


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Questions? Thank you!

EBIC Key Contact:

Dr. Alan Diener, PhD

Manager, Population Health EconomicsPublic Health Agency of Canada120 Colonnade Road Ottawa, Ontario K1A 0K9

Telephone : 613-952-2368

[email protected]


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Documents

Economic Burden of Illness in Canada (EBIC) 2014 Report by PHAC for 2005 – 2008 CPHA 2014 Conference Presentation Joe Devlin, Senior Health Economist Public