Transcript Presentation - Canadian Public Health Association

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
Economic Burden of Illness in Canada, 2005-2008
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
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Economic Burden of Illness in Canada, 2005-2008
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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Economic Burden of Illness in Canada, 2005-2008
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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Economic Burden of Illness in Canada, 2005-2008
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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Economic Burden of Illness in Canada, 2005-2008
Period of lost production using HCM
A
Yt-1
period of lost production
Yt
B
Yt+10
Period of lost production using FCM
A
Yt-1
C
period of lost production
Yt
A= Point individual becomes unable to work due to illness/injury
B= Point individual would reach retirement age or life expectancy
C= Point where job vacancy is filled (end of the friction period)
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B
Yt+10
Economic Burden of Illness in Canada, 2005-2008
Cost Estimates by Cost Type and Cost Component, Canada, 2005-2008
($’000,000 2010 Constant Dollars)
Direct Costs
Year
Total
Costs
Indirect Costs
Hospital
Care
Drug
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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Physician
Unattributable Subtotal Mortality Morbidity Unattributable Subtotal
Care
All
Economic Burden of Illness in Canada, 2005-2008
Cost Distribution by Cost Component for the Five Diagnostic
Categories with the Highest Total Costs, Canada, 2008
100%
8.9%
2.4%
2.9%
10.4%
12.1%
90%
22.1%
13.3%
11.7%
39.0%
80%
70%
19.1%
18.0%
31.0%
27.9%
38.7%
60%
22.6%
10.9%
50%
3.5%
Morbidity
Mortality
31.4%
Physician Care
40%
Drug
30%
55.3%
48.2%
20%
45.9%
47.4%
45.5%
28.5%
10%
0%
Neuropsychiatric
Conditions
$11.4 billion
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Cardiovascular
Diseases
$11.0 billion
Injuries
$7.5 billion
Musculoskeletal
Diseases
$6.3 billion
Digestive Diseases
$5.1 billion
Other Diagnostic
Categories
$42.9 billion
Hospital Care
Economic Burden of Illness in Canada, 2005-2008
Cost Distribution by Sex and Cost Component, Canada, 2008
100%
90%
20.0%
16.3%
80%
70%
12.5%
17.3%
60%
21.8%
50%
Morbidity
25.0%
Physician Care
40%
Drug
30%
20%
45.0%
41.1%
10%
0%
Male Cost
$44.6 billion
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Mortality
Female Cost
$45.8 billion
Hospital Care
Economic Burden of Illness in Canada, 2005-2008
Cost Distribution by Age Group and Cost Component, Canada, 2008
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Economic Burden of Illness in Canada, 2005-2008
EBIC – Beyond 2008?
PHAC is considering several next steps:
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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
Economic Burden of Illness in Canada, 2005-2008
Questions?
Thank you!
EBIC Key Contact:
Dr. Alan Diener, PhD
Manager, Population Health Economics
Public Health Agency of Canada
120 Colonnade Road
Ottawa, Ontario K1A 0K9
Telephone : 613-952-2368
[email protected]
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