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W E L C O M E

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W E L C O M E

WELCOME to the 2007 CADTH Invitational Symposium, a forum for producers and users ofevidence-based information and advice on drugs and other health technologies in Canada to connect,engage and work together to support informed decision making.

The theme this year is Informing Policy, Influencing Practice, Improving Health.

Decisions about the adoption, use and funding of drugs and other health technologies are crucial to thequality, affordability and sustainability of healthcare in Canada. They are also among the mostchallenging and controversial decisions Canada’s healthcare leaders have to make.

How can we link evidence to policy and practice more effectively in order to maximize health quality?What approaches have been effective in encouraging optimal practice by health professionals andconsumers? Is evidence-based advice having the desired impact? These are the types of questions theSymposium will address.

Over the next two days, you’ll learn more about initiatives underway across Canada to support theoptimal management and use of drugs and other health technologies in different settings and atdifferent stages of a technology's lifespan from introduction to optimal use and ultimately toobsolescence or replacement.

We’re proud that the Symposium continues to grow and improve – from 150 participants in 2005 tomore than 300 this year – with increased representation from across the country, more sessions, moreworkshops and new features such as Student Travel Grants.

We hope that you find the presentations and discussion over the next two days relevant and useful.

Simultaneous translation will be available for all plenary sessions. The concurrent sessions will beconducted in English only.

Informing Policy, Influencing Practice, Improving Health 2 0 0 7 C A D T H I n v i t a t i o n a l S y m p o s i u m

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SYMPOSIUM CHAIRDr. Jill M. Sanders, President and CEO, CADTH

SYMPOSIUM MODERATORPeter Chinneck, Director, Partnerships and Strategic Initiatives, CADTH

MEMBERSReiner Banken, Deputy Chief Executive Officer, Development and Partnerships, AETMIS Denis Bélanger, Director, COMPUS Topics and Research, CADTH Tammy Clifford, Director, Project Quality, HTA, CADTH Don Juzwishin, Juzwishin Consulting Inc.Braden Manns, Department of Medicine, Division of Nephrology, Foothills Medical Centre Janet Martin, Director, HiTEC, London Health Sciences Centre Bob Nakagawa, Assistant Deputy Minister, Pharmaceutical Services, British Columbia Ministry of Health Sandy Pagotto, Manager, CDR Reviews, CADTH David Reeleder, Policy Advisor, Ontario Ministry of Health and Long-term Care MaryEllen Schaafsma, Executive Director, Canadian Cochrane Network and Centre Sheila Tucker, Liaison Officer, Newfoundland and Labrador, CADTH John Yan, Director, Communications, CADTH

SYMPOSIUM COORDINATORSDiane Benner, Events Planning Officer, CADTH Donna Lachance, The Hillbrooke Group

P R O G R A M C O M M I T T E E

P R O G R A M A T A G L A N C E

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P R O G R A M A T A G L A N C EInforming Policy, Influencing Practice, Improving Health2007 CADTH Invitational SymposiumApril 23-24, 2007Crowne Plaza Hotel, Ottawa, ON

Sunday, April 22, 2007 PRE-SYMPOSIUM WORKSHOPS

TIME

0800 – 0900

0830 – 1700

0900 – 1200

0900 – 1200

1300 – 1430

1300 – 1500

LOCATION

Convention Level

ChaudièreConvention Level

JolietConvention Level

FrontenacConvention Level



SPEAKER

The CanadianCochrane Networkand Centre

S. Nancekevill

D. JuzwishinK. Krleza-JericL. Lehtiniemi

P. O’Blenis

M. Harczy A. KleinB. Manns

0730 – 1700

0730 – 0830

0830 – 0900

0900 – 1030

1030 – 1100

1100 – 1230

M. EvansJ. LexchinJ. Sanders

M. AllenJ. ButlerL. FarrellD. JuzwishinJ. O’Gorman

M. KrahnD. MartinJ. Martin

Lower Level

Ballroom Lobby

InternationalBallroom


Ballroom Lobby

RichelieuConvention Level

Victoria Lower Level

Monday, April 23, 2007

EVENT

Registration

Systematic Review Author Training

Writing Publishable Research Articles

A Holistic Policy and Regulatory Framework forDrugs and Medical Devices

Online Coded Reference Database Project –ESRNexus

The Use of Surrogate Endpoints in Drug Reviews

Registration

Breakfast

Official Opening

Opening Plenary: Informing Policy, InfluencingPractice, Improving Health

Refreshment Break

Concurrent Session 1Panel DiscussionPutting HTA into Practice: Challenges andSolutions

Concurrrent Session 2Oral PresentationsEquity, Ethics and Resource Allocation


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TIME

1230 – 1330

1330 – 1500

1500 – 1530

1530 – 1700

1700 – 1900

SPEAKER

E. IrvinK. Keown

P. Fortin/A. TejaniG. BrowmanR. Corvari

D. BélangerN. Debassige-Toeg/

K. GaebelS. Gavura

L. JobinD. Champagne/

L. Farrell/B. Ens/C. Mosher/J. Smith/S. Smith/J. Thompson/ A. Vosilla

R. RosenesC. Joudrie,K. Krleza-Jeric

G. DuchschererC. HarstallC. ThompsonJ. Winnick

C. BauchA. BayoumiB. Sander/A. Nizam

R. Banken H. Borowski/

D. SchopflocherM. Gaucher

B. MannsD. MartinG. MonteithT. Noseworthy (Chair)D. Wong-Reiger

LOCATION










Ballroom Lobby


Penthouse Level

EVENT

Concurrrent Session 3WorkshopStakeholder Involvement within the Institute forWork and Health Systematic Review Program

Concurrrent Session 4Oral PresentationsBlood, Cancer, Drug Utilization: New Tools forPolicy Makers

Concurrrent Session 5Oral PresentationsDrug Therapy Decisions: Processes, Impacts,Implications

Lunch

Concurrent Session 6WorkshopPartnerships from Coast to Coast – CADTH’sLiaison Program

Concurrent Session 7Oral PresentationsNew Data Sources:Trial Registration, Post-Approval Surveillance andData Warehouses

Concurrent Session 8Panel DiscussionCollaboration for HTA at the Front Line: The Caseof Inhaled Nitric Oxide (iNO) in the Managementof Acute Lung Injury/Acute Respiratory DistressSyndrome

Concurrent Session 9Oral PresentationsHealth Economics: Equity, Impact Evaluation andOther Considerations

Concurrent Session 10Oral Presentations:HTA and Health Policy: Recent DevelopmentsAcross Canada

Refreshment Break

Plenary Session:Expensive Drugs for Rare Diseases

Reception and Poster Viewing

P R O G R A M A T A G L A N C E

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TIME

0730 – 0830

0830 – 1000

1000 – 1030

1030 – 1200

1200 – 1330

1330 – 1500

1500 – 1515

EVENT

Breakfast

Plenary Session: Transparency in Drug Regulatoryand Funding Processes

Refreshment Break

Concurrent Session 11Oral PresentationsKnowledge Transfer and Exchange

Concurrent Session 12Oral PresentationsEvidence-based Decision Making on the FrontLines

Concurrent Session 13Oral PresentationsChallenging Policy Issues: Expensive Drugs forRare Diseases, Pandemic Influenza, AssistedReproductive Technologies

Concurrent Session 14Oral PresentationsEngaging Stakeholders

Concurrent Session 15Panel DiscussionInterventions to Facilitate Evidence-basedPrescribing and Drug Use: Evidence to InformPolicy Making

Lunch

Closing Plenary

Closing Remarks

SPEAKER

L. BabiakK. Kovacs BurnsE. LepineB. NakagawaB. Shea (Chair)M. Tierney

M. Allen/L. ReigerD. Angus/A. WongK. Gartenburg/

D. Champagne

E. Balka/J. JoyD. JuzwishinP. PoulinW. Ungar

K. GarcesJ. MartinM. McIsaac

C. Arratoon/A. Hammill/A. Stevens

K. Kovacs BurnsJ. Senécal/ K. Krleza-Jeric

S. GrahamJ. GrimshawA. MayhewN. Santesso

K. Moqadem/G. Pineau

T. NoseworthyA. Picard

J. Sanders

LOCATION

Ballroom Lobby


Ballroom Lobby









Tuesday, April 24, 2007


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P R E - S Y M P O S I U M W O R K S H O P SSunday April 22nd

0830 – 1700 Chaudière Room,Convention Level

0900 – 1200Joliet Room,

Convention Level

0900 – 1200 Frontenac Room,Convention Level

SYSTEMATIC REVIEW AUTHOR TRAININGPresenters: The Canadian Cochrane Network and Centre

The workshop provides the basic skills and knowledge required to conduct asystematic review to Cochrane standards, including planning a researchquestion, protocol development, literature searching, quality assessment, dataextraction, statistical analysis and drawing conclusions.

WRITING PUBLISHABLE RESEARCH ARTICLESPresenter: Sharon Nancekevill, Freelance Editor

This 3-hour workshop examines the principles of organizing and preparingoriginal research articles for publication. Through lecture, discussion, and briefexercises, participants learn about the process of getting a paper published andthe function and content of each section of a medical paper. The first half of theworkshop covers topics that authors fairly new to publishing need to understandabout writing publishable papers: journal editors' expectations, manuscriptprocessing at the journal, ethical issues of publication (e.g., duplicatepublication, authorship, consent), and steps in preparing papers for publication,from idea to submission. The second half covers common problems with eachsection of the paper (e.g., title, abstract, introduction, methods, results, anddiscussion), and time permitting, the common pitfalls of citing references,presenting tables and figures, and scientific writing style.

A HOLISTIC POLICY AND REGULATORY FRAMEWORK FOR DRUGS AND MEDICAL DEVICES

Workshop Leads: Don Juzwishin, Juzwishin Consulting (on behalf of MichaelCheng, International Development Worker) and Karmela Krleza-Jeric, CanadianInstitutes of Health ResearchAdditional Presenter: Leo Lehtiniemi, Consumer Commentator

The management and use of drugs and medical devices involve a wide range ofactivities by professionals and other stakeholders. A holistic policy and regulatoryframework is proposed to enhance an optimal outcome.

PRE-SYMPOSIUM WORKSHOPSSunday April 22nd

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This framework provides an overarching view of the key functions or activities ofstakeholders over the life span of products. It consists of three levels of policiesand regulations: 1) product market; 2) adoption and selection; and 3) utilizationand disposal. These three levels should function as a continuum withcollaborative interactions for optimal outcome. This framework provides allstakeholders including the Public with a simple common reference linkable tocomplex activities. All activities associated with a healthcare technology can beassessed with respect to their impact on each level. The workshop presentsguiding principles and tools applicable to medical devices for each level of theframework. Further development for drugs will be discussed.

ONLINE CODED REFERENCE DATABASE PROJECT – ESRNexusPresenter: Peter O’Blenis, TrialStat Corp.

In January of 2007, TrialStat Corp announced a new program to build acomprehensive, free, publicly searchable online database of coded referencescalled the Electronic Systematic Review Nexus (ESRNexus). The goal of thisproject is to advance the research process by allowing data captured during thesystematic review process to be easily published in a standardized format forsearching, review and reuse by other teams or individuals. The hope is that theavailability of coded reference data will improve the accuracy of searches andreduce the need to read entire documents in order to extract requiredinformation. Also, opening extracted data to public scrutiny may help to improvethe quality, credibility and transparency of the systematic review process. Thisworkshop will discuss the goals and methods of the ESRNexus project, providean overview of how to use the ESRNexus for searching and outline how otherscan participate in this project.

THE USE OF SURROGATE ENDPOINTS IN DRUG REVIEWSPresenters: Martha Harczy, Health Canada; Agnes Klein, Health Canada; BradenManns, Foothills Medical Centre

As clinical trials designed to assess the ultimate endpoint of a disease processcan be time consuming and expensive, surrogate endpoints are often used toreduce the cost and duration of phase III clinical trials. With increased interest inaccelerating drug development for innovative biological therapies, there will befurther emphasis on the use of surrogate endpoints for regulatory approval ofpharmaceuticals. This session will address:• the role of and challenges with surrogate endpoints for regulatory approval of

drugs• the challenges of using surrogate endpoints for reimbursement decisions for

new drugs• opportunities for collaboration on surrogate endpoints between regulators,

reimbursement decision makers and the pharmaceutical industry

1300 – 1430 Joliet Room,

Convention Level

1300 – 1500 Frontenac Room,Convention Level


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Registration

Breakfast

OFFICIAL OPENINGThe Symposium Chair will welcome symposium participants, briefly describesome of the symposium highlights and outline anticipated outcomes.

Dr. Jill M. Sanders, President and CEO, Canadian Agency for Drugs andTechnologies in Health

OPENING PLENARYInforming Policy, Influencing Practice, Improving Health

The Opening Plenary will bring the Symposium’s theme to life as three keynotespeakers explore various aspects of linking evidence to policy development,practice decisions and health quality and sustainability.

Where is Technology Taking Healthcare? Where is Healthcare Taking Technology?Dr. Jill M. Sanders, President and CEO, Canadian Agency for Drugs andTechnologies in Health

Dr. Google, Wikis, YouTube, and Chronic Disease Management: Innovation inPrimary CareDr. Michael Evans, Director of Knowledge Innovation and Patient Self Management,Department of Family and Community Medicine, University of Toronto

Whose Evidence, What Kind of Practice: Profits, Research and Medical PracticeDr. Joel Lexchin, Professor, School of Health Policy and Management, YorkUniversity

0730-1700International

Ballroom Lobby,Lower Level


Ballroom, LowerLevel





Monday, April 23rd

PRE-SYMPOSIUM WORKSHOPSMonday, April 23rd

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Refreshment Break

CONCURRENT SESSIONS

Putting HTA into Practice: Challenges and SolutionsPanel Discussion

Producing health technology assessment (HTA) reports is now a well developedprocess with standard methods of literature search, critical appraisal, statisticalanalysis, and reporting of results. However putting the findings of HTA reportsinto practice is much more problematic. Many factors may affect theimplementation of HTA reports: the influence of clinical practice guidelineswhich may contradict the report; the lack of awareness of HTA among physiciansand decision-makers; the difficulty of relating the report to local conditions,capacities, and resources; varying capacity to routinely look at evidence beforedecision making; and external pressures that are applied to adopt technology.

In this session, panel members will briefly present their ideas about thechallenges of putting HTA into practice in a range of contexts and jurisdictions.They will then engage the audience in discussion to obtain their perspectives onstrategies they have found successful and to identify further solutions.

Convenor:Michael Allen, Dalhousie University

Panelists:Janice Butler, Newfoundland and Labrador Centre for Applied Health ResearchLisa Farrell, Canadian Agency for Drugs and Technologies in HealthDon Juzwishin, Juzwishin ConsultingJoanne O’Gorman, Capital Health Region

Equity, Ethics and Resource AllocationOral Presentations

While evidence plays an essential role in decision making about healthtechnologies, factors such as economics and ethical issues of access are alsoimportant.

Moderator:Christa Harstall, Associate Director, Health Technology Assessment, Institute ofHealth Economics

A Strategy to Improve Priority SettingDouglas K. Martin, University of Toronto Joint Centre for Bioethics

Three Scientific Paradigms in Health Technology Assessment: Experiences of theCommittee to Evaluate Drugs in Ontario

1030-1100 International


1100-1230

SESSION 1Richelieu Room,

Convention Level

SESSION 2Victoria Room,

Lower Level


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Murray Krahn, Toronto General Hospital, University of Toronto, University HealthNetwork

Waking the SLEEPERs: Using “Know4Go” to Incorporate Social, Legal, Ethical, andPolitical Dimensions into Health Technology Decision Making Janet Martin, HiTEC, London Health Sciences Centre

Stakeholder Involvement within the Institute for Work and Health SystematicReview ProgramWorkshop

This interactive workshop will address the rationale for involving stakeholders ina systematic review. The group will discuss the identification and engagement ofstakeholders to provide feedback for reviews. In the course of the workshop wewill present information about various models the IWH has used to engagestakeholders (including policymakers, healthcare practitioners, health and safetyprofessionals) during various steps of a systematic review including: topicselection, defining the research question, refining the search terms, reviewingthe literature, extracting messages for dissemination. The benefits andchallenges of the various models of involvement will be discussed. Differentstrategies to engage the groups of stakeholders will be presented. Theinteractive nature of the workshop will allow participants to share theirexperiences in stakeholder engagement and potential models they haveemployed.

Workshop Lead:Kiera Keown, Institute for Work and Health

Co-Presenter:Emma Irvin, Institute for Work and Health

Blood, Cancer, Drug Utilization: New Tools for Policy MakersOral Presentations

From a national drug information system to a new method of ranking cancerdrugs for regional funding decisions, this session focuses on new tools to helppolicy makers incorporate best evidence into funding decisions.

Moderator:Brendalynn Ens, Liaison Officer, Canadian Agency for Drugs and Technologies inHealth

A New Tool for Fair Decisions for Cancer Drug FundingGeorge Browman, BC Cancer Agency

Building Capacity: Using Evidence in Utilization Management of Immune GlobulinTherapyAaron Tejani, Therapeutics Initiative, University of British ColumbiaPatricia Fortin, BC Blood Coordinating Office

Session 3Chaudière Room,Convention Level

Session 4Frontenac Room,Convention Level


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National Prescription Drug Utilization Information System (NPDUIS)Ron Corvari, Patented Medicine Prices Review Board

Drug Therapy Decisions: Processes, Impacts, ImplicationsOral Presentations

This session focuses on the integration of evidence into drug policy and drugtherapy decision making by front line health care professionals.

Moderator:Susan Groves, Chair, Federal Drug Benefits Committee, Canadian ForcesPharmacists Maintenance of Competency Program

Development of Health Technology Assessment Skills in a Drug Information CentreScott Gavura, Drug Information and Research Centre, Ontario Pharmacists'Association

Impact of the Implementation of COMPUS PPI MessagesDenis Bélanger, Canadian Agency for Drugs and Technologies in Health

A Therapeutic Substitution Policy for Proton Pump Inhibitors: Aboriginal patientsBurden of IllnessNeda Debassige-Toeg, Aboriginal Pharmacists Association of Canada Kathryn Gaebel, Centre for Evaluation of Medicines (CEM), St Joseph’s Healthcare,Hamilton

Lunch

CONCURRENT SESSIONS

Partnerships from Coast to Coast – CADTH’s Liaison ProgramWorkshop

The Liaison Program was established in 2004 to strengthen relationshipsbetween the Canadian Agency for Drugs and Technologies in Health (CADTH)and Canadian health jurisdictions. Liaison Officers increase access to andunderstanding of evidence-based information to inform health care policy andpractice decisions. This session will provide an interactive forum to increaseunderstanding of the Liaison Program, its activities and future directions.Workshop Lead:Lynda Jobin, Canadian Agency for Drugs and Technologies in Health

Co-Presenters:Donna Champagne, Canadian Agency for Drugs and Technologies in HealthLisa Farrell, Canadian Agency for Drugs and Technologies in Health

Session 5Joliet Room,

Convention Level



1330-1500



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Session 7Richelieu Room,

Convention Level


Convention Level

Brendalynn Ens, Canadian Agency for Drugs and Technologies in HealthCindy Mosher, Canadian Agency for Drugs and Technologies in HealthJeannette Smith, Canadian Agency for Drugs and Technologies in HealthStephanie Smith, Canadian Agency for Drugs and Technologies in HealthJoyce Thompson, Canadian Agency for Drugs and Technologies in HealthAnn Vosilla, Canadian Agency for Drugs and Technologies in Health

New Data Sources: Trial Registration, Post-Approval Surveillance and Data WarehousesOral Presentations

This session looks at data sources that may help support adoption decisions formedical devices, evidence-based formulary listing decisions and effectivemanagement of drug therapies.

Moderator:Ian McKillop, Executive Director, Health Research, University of Waterloo

PEI Drug Information System - Data WarehouseCalvin Joudrie, Island Health Information System

Trial Registration as a Tool of Decision Making, Providing Evidence for Adoption ofNew Drugs and Devices and Strengthening People’s Trust; Canadian Institutes ofHealth Research (CIHR) and Global PerspectiveKarmela KrleÏa-Jeriç, Canadian Institutes of Health Research

Evidence-Based Formulary Listing Decisions: The Need for an Improved Post-Approval Surveillance SystemRon Rosenes, Canadian Treatment Action Council

Collaboration for HTA at the Front Line: The Case of Inhaled Nitric Oxide (iNO) inthe Management of Acute Lung Injury/Acute Respiratory Distress SyndromePanel Discussion

In keeping with their commitment to high-quality care, the Calgary HealthRegion (CHR) Respiratory Services Department sponsored their ClinicalDevelopment Specialist as a participant in SEARCH Classic. In this intensive twoyear program, staff from health organizations, are mentored by academic facultyto build capacity to “use”, “choose” and “create” evidence for application topractice, policy and service delivery. In this case, a tenfold increase in costscoupled with uncertain clinical benefits, prompted the need for an evidence-based policy regarding inhaled Nitric Oxide therapy for adults with acuterespiratory failure. Through a collaboration between CHR, the Institute of HealthEconomics, and SEARCH Canada, the Specialist completed a Health TechnologyAssessment to address this issue. During the panel presentation, the partners inthis project will discuss the effectiveness of this collaboration both in terms ofaddressing a local need and in creating ongoing capacity to support evidence-based practice.


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Session 9Victoria Room,

Lower Level

Session 10Frontenac Room,Convention level

Convenor:Greg Duchscherer, Calgary Health Region

Panelists:Christa Harstall, Institute of Health EconomicsChristine Thompson, SEARCH CanadaJim Winnick, Calgary Health Region

Health Economics: Equity, Impact Evaluation and Other ConsiderationsOral Presentations

Economic evaluations provide essential information to support health policydevelopment. From the development of pandemic influenza mitigationstrategies to the evaluation of Hepatitis A vaccination, this session looks at therole, strengths and limitations of economic evaluations.

Moderator:Karen Lee, Manager Health Economics, Canadian Agency for Drugs andTechnologies in Health

Methodological Issues in Cost-Effectiveness Evaluation of Targeted Versus UniversalHepatitis A Vaccination in Canada Chris Bauch, University of Guelph

Economic Evaluation of Influenza Pandemic Mitigation Strategies in the US Usinga Stochastic Microsimulation Influenza Model Beate Sander, Toronto General Hospital, University of Toronto, University HealthNetwork

What Needs Adjustment in Cost-Effectiveness Analysis to Capture Equity Concerns?Ahmed Bayoumi, Centre for Research on Inner City Health, St. Michael's Hospital,TorontoAzhar Nizam, Emory University

HTA and Health Policy: Recent Developments across CanadaOral Presentations

This session provides an opportunity to learn about recent developments inhealth technology assessment and health policy in various jurisdictions. It willinclude an update on the Health Technology Strategy Policy Forum, a pan-Canadian initiative.

Moderator:Don Juzwishin, Juzwishin Consulting

Health Policy & Technology Assessment: Recent Developments in AlbertaHenry Borowski, Alberta Health and WellnessDon Schopflocher, Institute of Health Economics, Alberta Health and Wellness


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1700-1900

HTA and Health Policy Developments in QuebecReiner Banker, Agence d'évaluation destechnologies et des modes d'interventionen santé (AETMIS)

The Health Technology Strategy Policy ForumMike Gaucher, Canadian Agency for Drugs and Technologies in Health (CADTH)

Refreshment Break

PLENARY SESSION

Expensive Drugs for Rare Diseases

Drugs used to treat rare, life-threatening diseases pose considerable challengesto evidence-based decision making on public reimbursement. The small numberof patients involved makes the conduct of large randomized trials difficult. Thereare sometimes no other options to treat the disease. The cost of drugs to treatrare diseases is often high. These considerations can raise ethical issues. Thispanel will provide various perspectives on the issues, options and implications.

Moderator:Tom Noseworthy, Professor and Director, Centre for Health Policy Studies,University of Calgary

Panellists:Braden Manns, Associate Professor, University of Calgary and Chair, CanadianExpert Drug Advisor Committee (CEDAC)Doug Martin, Associate Professor, Department of Health Policy, Management andEvaluation and Joint Centre for Bioethics, University of TorontoGlenn Monteith, Executive Director, Pharmaceutical Policy & Programs, AlbertaHealth & WellnessDurhane Wong-Rieger, President, Canadian Organization for Rare Disorders

RECEPTION AND POSTER VIEWINGPinnacle Room and Panorama Room, Penthouse Level

PRE-SYMPOSIUM WORKSHOPSTuesday, April 24 2007

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Registration

Breakfast

PLENARY SESSION

TRANSPARENCY IN DRUG REGULATORY AND FUNDING PROCESSES

Much of the information on drugs used to inform regulatory and fundingprocesses is unavailable to researchers and the public. Do we have the rightapproach to transparency and accountability in Canada? Panellists discuss theissues and options from a variety of perspectives.

Moderator:Barb Shea, Vice-President, Canadian Optimal Medication Prescribing andUtilization Service (COMPUS), Canadian Agency for Drugs and Technologies inHealth

Panelists:Lesia Babiak, Director, Federal Affairs & Health Policy, Janssen Ortho Inc.Katharina Kovacs Burns, Associate Director, Health Sciences Council, University ofAlbertaErin Lepine, Manager, Policy and Planning, Office of Consumer and PublicInvolvement, Health CanadaBob Nakagawa, Assistant Deputy Minister, Pharmaceutical Services, BritishColumbia Ministry of HealthMike Tierney, Vice-President, Common Drug Review (CDR), Canadian Agency forDrugs and Technologies in Health

Tuesday, April 24 2007


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1030-1200

Session 11Frontenac Room,Convention Level

Session 12Richelieu Room,

Convention Level

Refreshment Break

CONCURRENT SESSIONS

Knowledge Transfer and ExchangeOral Presentations

This session highlights initiatives designed to bridge the gap between healthresearch and health policy and health practice.

Moderator:Craig Larsen, Director, Knowledge Transfer, Canadian Agency for Drugs andTechnologies in Health

Academic Detailing Plus: The Benefits of Academic Detailing Beyond ClinicianEducationMichael Allen, Dalhousie CMELoren Regier, The RxFiles - Academic Detailing Program

Knowledge Translation of HTAs for Policy Makers Donna Angus, Alberta Heritage Foundation for Medical ResearchAmy Wong, Alberta Heritage Foundation for Medical Research

Engaging Decision Makers in HTA Research: Lessons Learned from the KnowledgeTransfer of CADTH’s Emergency Department Overcrowding HTA Kirsten Gartenburg, Canadian Agency for Drugs and Technologies in HealthDonna Champagne, Canadian Agency for Drugs and Technologies in Health

Evidence-based Decision Making on the Front LinesOral Presentations

Many of the key decisions about technology uptake and use are made at theregional and facility levels. This session highlights initiatives designed to improvethe use of evidence in health technology decision making on the front lines.

Moderator:Kenneth Baird, Vice President, Clinical and Facility Support Services, Atlantic HealthSciences

The Alberta Regional Health Technology Assessment DemonstrationDon Juzwishin, Juzwishin Consulting

Technology Assessment at Sick Kids (TASK): A Model for a Health TechnologyAssessment Unit in a Pediatric Tertiary Care and Research CentreWendy Ungar, Hospital for Sick Children, Toronto

Adapting a Local Health Technology Decision Support Program to VariousDepartments within a Health RegionPaule Poulin, Foothills Medical Centre, Calgary Health Region


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Convention Level


Evidence Based Technology Purchasing? Successes and Challenges in Improving theUse of Evidence in Health Technology Decision MakingEllen Balka, Simon Fraser University, Vancouver Coastal HealthJanet Joy, Vancouver Coastal Health

Challenging Policy Issues: Expensive Drugs for Rare Diseases, Pandemic Influenza,Assisted Reproductive TechnologiesOral Presentations

Evidence-based information and advice is used to support informed decisionmaking about complex policy issues. This session looks at the evidence-policyconnection with respect to pandemic influenza and other hot topics.

Moderator:Tammy Clifford, Director, Project Quality, HTA, Canadian Agency for Drugs andTechnologies in Health

Review of Issues Associated with Assisted Reproductive Technologies (ARTs) andPreimplantation Genetic Diagnosis (PGD)Michelle McIsaac, Foothills Medical Centre, University of Calgary

An Example of the Health Technology Inquiry Service (HTIS) Supporting National Decision Making: Antiviral Prophylaxis for Pandemic InfluenzaKirsten Garces, Canadian Agency for Drugs and Technologies in Health

Expensive Drugs for Rare Diseases: Stories from the Coal-FaceJanet Martin, HiTEC, London Health Sciences Centre

Engaging StakeholdersOral Presentations

Strategic partnerships and expanded stakeholder engagement are becoming thenorm as organizations work to bridge the gap between research, policy andpractice. This session outlines engagement frameworks used by differentorganizations.

Moderator:Heather Bennett, Manager, Best Practices Recommendations, COMPUS, CanadianAgency for Drugs and Technologies in Health

Expanding stakeholder involvement to improve understanding and use ofCochrane reviewsCheryl Arratoon, The Canadian Cochrane Network and CentreAmanda Hammill, McMaster University;Adrienne Stevens, The Canadian Cochrane Network and Centre

Best Practice Patient Engagement Framework for Decision MakersKatharina Kovacs Burns, University of Alberta & Best Medicines Coalition


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Session 15Victoria Room,

Lower Level





Partnership for Clinical Research: CIHR Clinical Research InitiativeJulie Senécal, Canadian Institutes for Health ResearchKarmela Krleza-Jeric, Canadian Institutes of Health Research

Interventions to facilitate evidence-based prescribing and drug use: Evidence toinform policy decision makingPanel Discussion

Evidence about the effects of drugs and health technologies is one of theprimary elements in health care decision making at a policy level. It follows thatevidence about interventions to promote evidence-based prescribing and use ofthose effective drugs and health technologies should also be used to informthose decisions. Review evidence for these interventions has been systematicallysearched, appraised, analyzed and summarised by the Cochrane Effective Practiceand Organisation of Care and the Consumers and Communication ReviewGroups. The panel will present the following with time for discussion:• A description of the methods used to collect, evaluate and summarize

information from existing systematic reviews.• A summary of the findings of interventions targeting professionals and

prescribing behaviour and the gaps in the evidence.• A summary of the findings of interventions targeting patients and drug use

and the gaps in the evidence.

Convenor:Jeremy Grimshaw, Ottawa Health Research Institute

Panelists:Stephen Graham, Canadian Agency for Drugs and Technologies in Health Alain Mayhew, Canadian Cochrane Network and Centre Nancy Santesso, Canadian Cochrane Network and Centre

Lunch

PLENARY PRESENTATIONS

EVALUATING MEDICAL DEVICES

What can we learn about assessing devices from drug evaluation processes?What evidence and information do policy makers and other decision makersneed at different stages of a device’s lifecycle – from innovation to obsolescence?

Assessing Telepsychiatry: From device to health servicesKhalil Moqadem, AETMISGilles Pineau, AETMIS


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Obsolescence of Health TechnologiesTom Noseworthy, Professor and Director, Centre for Health Policy Studies,University of Calgary

PLENARY PRESENTATION

Is Coverage of Health Stories in the Canadian Media Healthy?

The final presentation provides an insider’s look at one of the key influencers ofthe health care agenda in Canada – the media. Patient expectations, politicalagendas, policy decisions can all be affected, not only by the health stories thatare covered, but the way they are covered as well. What does this mean forproducers and users of evidence-based information on drugs and othertechnologies?

André Picard, Public Health Reporter, Globe and Mail

OFFICIAL CLOSING

The Symposium Chair will officially bring the symposium to a close.

Dr. Jill M. Sanders, President and CEO, Canadian Agency for Drugs andTechnologies in Health


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LESIA BABIAK is Director, Federal Affairs & Health Policy with Janssen Ortho Inc.Prior to joining Janssen in 2000, she spent five years with the Ontario Ministry ofHealth as the Associate Director, Drug Programs Branch, where herresponsibilities included managing the drug submission and evaluation process,the Special Drugs program and individual clinical reviews (Section 8 process). Shealso led three submission streamlining initiatives and a number of clinicallyoriented initiatives including PPI review, Antibiotic review, and FormularyModernization initiatives. Lesia has a BscPharm from the University of Toronto, aPharmD from Wayne State University and a MBA from the University of WesternOntario. [Plenary April 24 0830 – 1000]

MICHAEL EVANS is a family physician working at the Toronto Western Hospital.He holds a cross-appointment to the University of Toronto as an AssociateProfessor, Department of Family and Community Medicine where he hasrecently been appointed Director of Knowledge Innovation and Patient SelfManagement. Dr. Evans' academic work has focused on innovative solutions formaking evidence-based decisions easier for both patients and primary careclinicians. This includes his work as founding Director of the Mini-Med Schoolfor the public at the University of Toronto, founder and editor of the critical-appraisal section of the Canadian Family Physician, Chair of the OntarioProgram for Optimal Therapeutics that has developed guidelines for many

diseases, and founder of Health Knowledge Central, a multimedia resource for busy clinicians. He isthe Chief Editor for the Family Practice Sourcebook, the top selling primary care textbook inCanada. Dr. Evans was a member of Ontario's Drug Quality and Therapeutics Committee (DQTC),and is currently appointed to the Canadian Expert Drug Advisory Committee. He has alsoparticipated on or chaired several subcommittees related to formulary modernization and otherMinistry formulary initiatives. [Plenary April 23 0900 - 1030]

KATHARINA (KATHY) KOVACS BURNS is Associate Director, Health SciencesCouncil at the University of Alberta, where she coordinates interdisciplinaryhealth partnerships and initiatives in research, education and services includingwith community sectors. Previously, she was with the Faculty of Nursing,University of Alberta, and with the Alberta Government. Her personal researchprogram focuses on (1) public engagement in local, national and internationalhealth and social policy and program decisions, and (2) the impact of publichealth and social policies on the public, particularly vulnerable or marginalizedpopulations including patients with chronic diseases/conditions, women,youth/children, seniors and people with low income. Her work and research link

closely with her current volunteer community and committee work including with the Best MedicinesCoalition Canada, International Alliance of Patient Organizations, Patients for Patient Safety (global,

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regional and Canadian), Council on Rare Disorders (CORD), and with various government departmentsand advisory groups. [Plenary April 24 o830 - 1000: Session 14 April 24 1030 – 1200]

ERIN LEPINE is Manager, Policy and Planning, Office of Consumer and Public Involvement, HealthProducts and Food Branch, Health Canada. Erin was hired by Health Canada in 1999 to work withnational seniors organizations and to help prepare the Government of Canada’s response to theUnited Nations’ World Assembly on Ageing (Madrid, 1999). Since 2000, she has worked with OCAPI to bring public input into policy, science, and regulatory-based decisions of the Branch. Most recently,she coordinated the Department’s first ever public forum on Selective COX-2 Inhibitors. Prior to herbecoming a public servant, Erin worked in the field of community health. She is a trained facilitatorand mother of two boys. She has a Bachelor’s degree with concentrations in political science andhistory from the University of Ottawa. [Plenary April 24 0830 – 1000]

JOEL LEXCHIN received his MD from the University of Toronto in 1977 and for thepast 19 years has been an emergency physician at The University Health Network.He is currently a Professor in the School of Health Policy and Management at YorkUniversity and an Associate Professor in the Department of Family andCommunity Medicine at the University of Toronto. He has been a consultant onpharmaceutical issues for the province of Ontario, various arms of the Canadianfederal government, the World Health Organization, the government of NewZealand and the Australian National Prescribing Service. He is the author or co-author of over 70 peer-reviewed articles on topics such as physician prescribingbehaviour, pharmaceutical patent issues, the drug approval process and

prescription drug promotion. [Plenary April 23 0900 – 1030]

BRADEN MANNS is a Specialist in Kidney Diseases and Associate Professor at the University ofCalgary in the Departments of Medicine and Community Health Sciences. He has a Masters in HealthEconomics from York University in England, and has a broad understanding of the role of economicevaluation in pharmaceutical policy and decision making. Dr. Manns teaches a graduate courseentitled "Decision Analysis within Health Care Economic Evaluation," and is widely published in thearea of health economics. He has been a member of CEDAC since 2003 and is a past member of theExpert Drug Evaluation and Therapeutics Committee for Alberta Health and Wellness. [Pre-symposium Workshop April 22 1300 – 1500; Plenary April 23 1530 - 1700]

DOUG MARTIN is an Associate Professor, Department of Health Policy, Management and Evaluation,and the Joint Centre for Bioethics, University of Toronto. He is Leader of the Canadian Priority SettingResearch Network and Past-Chair of the International Society for Priorities in Health Care. He is abioethics and health policy scholar and has consulted with government policy makers on 5 continents.Over the past decade he has published over 35 papers on improving priority setting/resource allocationin health systems. [Session 2 April 23 1100 – 1230; Plenary April 23 1530 - 1700]


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GLENN MONTEITH, prior to joining Alberta Health and Wellness, was VicePresident of a strategic communications company based in Victoria. As well,Glenn held several senior positions with GlaxoSmithKline and its predecessorcompanies, GlaxoWellcome and SmithKline Beecham. From 1990-96, Glenn was aSenior Consultant and later a principal with a consulting firm based in EasternCanada that specialized in health care and pharmaceuticals initiatives in both thepublic and private sector. Glenn also served as Senior Economist at SaskatchewanHealth. Over the course of his career, Glenn has worked on projects for everyprovincial government as well as for the federal government. As well, he hasextensive health and pharmaceuticals consulting experience with a wide range

of private sector, NGO and health advocacy groups. [Plenary April 23 1530 - 1700]

KHALIL MOQADEM is a Doctor in Medicine from the Faculty of Medicine, in Casablanca. He holds aMBA from the Université Laval and is a PhD candidate (Public Health) at the Health AdministrationDepartment of the Université de Montréal. Dr. Moqadem’s special interest is in the informationtechnologies and their application in medical practice. In 2004, he joined AETMIS in the capacity ofconsultant researcher within the Telehealth Unit. [Plenary April 24 1330 – 1500]

BOB NAKAGAWA is currently the Assistant Deputy Minister, PharmaceuticalServices for British Columbia. He is a pharmacist who has worked both inhospitals and in government in developing innovative services and policies forthe last 3 decades. He has served as President of the College of Pharmacists of BC,as well as the Canadian Society of Hospital Pharmacists. Bob has chaired theDrug Benefits Committee for BC PharmaCare and the Federal Pharmacy andTherapeutics Committee for Canada. He is the Federal government appointee tothe Health Council of Canada. Bob is an adjunct professor in the Faculty ofPharmaceutical Sciences and an associate member of the Faculty of Medicine atUBC. [Plenary April 24 0830 - 1000]

TOM NOSEWORTHY is Director, Centre for Health and Policy Studies, Professor(Health Policy and Management) and Head, Department of Community HealthSciences, University of Calgary. He is a Clinical Advisor to Alberta Health andWellness for the Province’s developing health information system. He is Chair ofthe Western Canada Waiting List Project. Dr. Noseworthy is the former VicePresident, Medical Services, and CEO of the Royal Alexandra Hospitals, and Chairof the Department of Public Health Sciences, Faculty of Medicine and Dentistry,University of Alberta. He holds a Master of Science in Experimental Medicinefrom the University of Alberta, and a Master of Public Health - Health Policy andManagement from Harvard University. Dr. Noseworthy is a physician with

specialty certification in the Royal College of Physicians and Surgeons of Canada, and the AmericanColleges of Physicians, Chest Physicians, and Critical Care Medicine. Dr. Noseworthy has been amember of the National Statistics Council since 1999, and is currently a member of the AdvisoryCommittee on Information and Emerging Technologies (F/P/T Deputy Ministers of Health). He servedas a member of the Prime Minister’s National Forum on Health from 1994-1997, and chaired theSteering Committee; co-chaired the Advisory Council on Health Infostructure (Federal Minister) from1997-1999, and chaired the Senior Reference Committee for Alberta Wellnet from 1997-2002. Hisresearch has been published in over 70 papers and book chapters and includes a focus on optimisingclinical practice behaviours and patient outcomes, and improving quality management of waitingtimes for scheduled services. [Plenary April 24 1330 - 1500]


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ANDRÉ PICARD is one of Canada's top public policy writers. He is currently thepublic health reporter at The Globe and Mail, where he has been a staff writersince 1987. He also serves as the paper's Quebec Bureau Chief. He is the author ofthe best-selling books CRITICAL CARE: Canadian Nurses Speak For Change andTHE GIFT OF DEATH: Confronting Canada's Tainted Blood Tragedy. He is also theauthor of A CALL TO ALMS: The New Face of Charity in Canada. André has receivedmuch acclaim for his writing, including the Canadian Nurses' Association Awardof Excellence in 2000 and 2001, the Michener Award for Meritorious PublicService Journalism, the Canadian Policy Research Award, the Science and SocietyPrize, and the Atkinson Fellowship for Public Policy Research. He has been a three-

time finalist for the National Newspaper Awards, a nominee for the Gordon Montadour Award forPublic Policy Writing, and the QSPELL Award for Non-Fiction. His work has also been honoured by theCanadian Hearing Society. André lives in Montreal. [Plenary April 24 1330 - 1500]

JILL M. SANDERS was appointed President and CEO of the Canadian Agency forDrugs and Technologies in Health in 1997. She is responsible for the overallmanagement and strategic direction of CADTH and its directorates and has ledCADTH`s evolution into a primary source for unbiased, evidence-basedinformation to support the optimal management of drugs and other healthtechnologies. Her previous experience spans from medical imaging to spaceshuttle mission management. Dr. Sanders is a member of the Health TechnologyAssessment International Board, Chair of Euroscan, and is the internationaladvisor to the UK HTA Program. She holds Honours and Master’s Degrees inPhysics as well as a PhD in Medical Physics. [Plenary April 23 0900 – 1030]

MIKE TIERNEY is the Vice-President of the Common Drug Review (CDR) at theCanadian Agency for Drugs and Technologies in Health (CADTH). Prior to joiningCADTH as the Director of the CDR in May 2005, he held a variety of positions overa long career in hospital pharmacy including Director of Pharmacy at The OttawaHospital where he continues to maintain an appointment as a clinicalpharmacist. He has authored over 30 original research publications andnumerous reviews, editorials and book chapters. Mike obtained his B.Sc.Phm.from the University of Toronto, a M.Sc. in Pharmacology from the University ofOttawa and completed a hospital pharmacy residency program at the OttawaGeneral Hospital. [Plenary April 24 0830 – 1000]

DURHANE WONG-RIEGER is president of the Canadian Organization for RareDisorders and President and CEO of the Institute for Optimizing HealthOutcomes. She is secretary to the Canadian Fabry Association and the CanadianHepatitis C Network. She is also founder and head of Consumer AdvocareNetwork, a national network to provide a common voice for patientorganizations. She is a licensed Master Trainer with the Stanford-based Living AHealthy Life with Chronic Conditions. Dr. Wong-Rieger has served on numeroushealth policy advisory committees and panels, including Project Coordinator forthe Policy Dialogues for the Romanow Commission on the Future of Healthcare inCanada, consultant to the Ontario Premier’s Advisory Board on Organ Donation,

and member of the board of the Canadian Blood Services and National Blood Safety Council. She hasa PhD in psychology from McGill University. [Plenary April 23 1530 - 1700]


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CHRISTINE ALBINO holds the position of Senior Analyst, Public Affairs and Government Relations atIMS Health, Canada. She holds a Masters degree in Pharmacology from the University of Toronto anda Graduate Certificate in Biotechnology from McGill University. Prior to IMS, Ms. Albino worked as aResearch Assistant at McGill University. [Poster presentation April 23 1700 – 1900]

MICHAEL ALLEN graduated from Dalhousie Medical School in 1975. He worked as a family physician in rural and urban areas of Nova Scotia for 17 years before joining Dalhousie Continuing MedicalEducation in 1994. Working in rural areas has given Dr Allen an appreciation of the demands placedon health care professionals in these communities, and the importance of continuing education tothem. To meet these educational needs he has directed face-to-face “visiting professor” programs, andhas helped start provincial videoconferencing and academic detailing programs. He also helped formthe Canadian Academic Detailing Collaboration that unites academic detailing programs in fiveprovinces. He has been developing evidence-based continuing education programs since 2001 andrecently chaired the Maritime Provinces Symposium on Health Technology Assessment. He is nowstudying for a masters degree in community health and epidemiology. [Session 1 April 23 1100 – 1230;Session 11 April 24 1030 – 1200]

DONNA ANGUS is the Manager, Research Transfer Initiatives with the Alberta Heritage Foundation for Medical Research. Part of her portfolio includes managing the Health Research Transfer Networkof Alberta (RTNA). Established in 2002, the RTNA is a province-wide network of more than 300researchers, health care professionals, and policy makers that undertakes activities to strengthen theuse of research findings to inform decision making in health care in Alberta. Donna also supports thedissemination and research transfer activities at the Foundation and is part of research projects onresearch and knowledge transfer such as the Ambassador Program. Donna has a BEd and a Mastersof Science in Administration (Health Services) and has worked in the health care field for all of herworking career. She is a certified Medical Writer with the American Medical Writers Association.[Session 11 April 24 1030 – 1200]

CHERYL ARRATOON is the Knowledge Broker at the Canadian Cochrane Network and Centre. Sheacquired her MSc at the University of Western Ontario in 1984 which led to positions in basic researchat the Bureau of Medical Biochemistry, Health Canada and the Department of Pathology, Universityof British Columbia. She then spent three years in the Drug Regulatory Affairs Division of HealthCanada. Her work in science outreach started as Coordinator of Vancouver’s ‘Visiting ScientistProgram’ funded by the Society for Canadian Women in Science in Technology. She continueddeveloping in this area over 10 years with the Canadian Agency of Drugs and Technologies (CADTH) as the organization experienced tremendous growth. She built and managed the first production andcommunications team, initiated the first knowledge transfer activities and initiated and implementedCADTH’s national Liaison Program during several roles at CADTH. She currently facilitates Cochranerelated knowledge transfer activities linking with health professional associations and is expandingCochrane’s consumer network in Canada. [Session 14 April 24 1030 – 1200]

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ELLEN BALKA is a professor in Simon Fraser University's School of Communication, and a SeniorResearch Scientist at Vancouver Coastal Health Research Institute's Centre for Clinical Epidemiologyand Evaluation. Building on her background in technology assessment which included a focus on fieldbased assessments of technology use in context, Dr. Balka has focused on the assessment of healthtechnologies — and particularly the use of information technologies in the health sector, for the lastdecade. She is the principle investigator of a 4 year $3 million SSHRC funded project concerned withthe role of technology in the production, consumption and use of health information. She also servedas the principle investigator of a recently completed synthesis of literature concerned with Health,Technology, Governance and Patient Safety. As a co-investigator of Dr. Janet Joy's recently awardedCADTH grant, Dr. Balka is working to support increased use of technology assessment withinhealthcare organizations. [Session 12 April 24 1030 – 1200]

REINER BANKEN obtained his medical degree from Université de Montréal, where he also earned a master’s degree in Community Health. Consultant Researcher for AETMIS since 1998, he holds theposition of Deputy Chief Executive Officer, Development and Partnerships since July 2005. He workedas an emergency physician for five years and as a specialist in public health for 12 years, includingserving as Public Health Director for Québec’s Laurentian region. Author of several publications and a sought-after speaker in the field of public health, Dr. Banken also often serves as a consultant tointernational organizations such as the European Centre for Health Policy and the Pan-AmericanHealth Organization (PAHO), a division of the World Health Organization (WHO). In July 2006, Dr.Banken has been elected Vice President of HTAi (Health Technology Assessment International), anorganization whose mission is to support the development, communication, understanding and useof HTA around the world. [Session 10 April 23 1330 – 1500]

CHRIS T. BAUCH, PhD is a specialist in mathematical modelling of the transmission of infectiousdiseases (i.e. dynamic models), and their applications in cost-utility and cost-effectiveness analysis.He is an Assistant Professor of Mathematics at the University of Guelph. He completed a Bachelor inScience in Physics from the University of Texas at Austin, a diploma in Theoretical Physics from theUniversity of Cambridge, a diploma in religious studies from the same, and a PhD in Mathematicsfrom the University of Warwick, England. He studied as a postdoctoral researcher with David Earn at McMaster University before coming to Guelph. Recent projects include estimating the cost-effectiveness of universal Hepatitis A vaccination in Canada and modelling of vaccinating behaviourfor pediatric infectious diseases under a voluntary vaccination policy. [Session 9 April 23 1330 – 1500]

AHMED BAYOUMI is a general internist and a scientist at the Centre for Research on Inner City Health at St. Michael’s Hospital in Toronto and the Director of the Clinical Epidemiology Program atthe University of Toronto. He holds appointments in the Departments of Medicine and Health Policy,Management and Evaluation. He trained in Internal Medicine and Clinical Epidemiology (M.Sc.) inToronto and completed a fellowship in Health Policy at Stanford. His research focuses on applyingdecision sciences and clinical epidemiology to the care of people living with HIV and othermarginalized populations. He has expertise in cost effectiveness analysis, preference-basedmeasurement, and working with large observational cohorts. [Session 9 April 23 1330 – 1500;Poster presentation April 23 1700 - 1900]

DENIS BÉLANGER, as the Director of Topics and Research for the COMPUS program at CADTH,leads a multidisciplinary team of researchers responsible for developing the clinical and economicinformation that formed the basis for the Expert Review Panel’s work in PPI’s. To ensure COMPUS’work is fair and transparent, there was opportunity for feedback from external agencies and otherinterested parties at specific points in the process. Denis is a pharmacist with several years experienceas a hospital based Drug Information Specialist. [Session 5 April 23 1100 – 1230]


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SANDRA BERZINS is a research associate in the department of Community Health Sciences at theUniversity of Calgary, where she focuses on knowledge synthesis and health technology assessment.Prior to this position, Sandra worked in a wide range of health care areas including chronic diseasemanagement, mental health, community health promotion and organizational development. Hervaried research interests include health systems research, knowledge transfer and physiciancommunications, as well as evaluation of community health interventions. Sandra’s academicbackground includes a BSc in Psychology, University of Alberta, and MSc in Health Behaviour from the University of Waterloo. [Poster presentation April 23 1700 – 1900]

HENRY BOROWSKI is Director of Health Technologies and Services Policy Branch at Alberta Health andWellness. The Branch manages the Alberta Health Technologies Decision Process, facilitates the work ofthe Alberta Advisory Committee on Health Technologies, manages provincial reviews of specific healthservices, is the Ministry lead on health technology assessment initiatives, and provides advice relatingthe funding of health services. He was recently appointed as the Alberta representative to the HealthTechnology Policy Forum. He supported the work of the Expert Advisory Panel to Review PubliclyFunded Health Services and subsequently, has led implementation of the government’s response tothe Expert Panel’s advice regarding improved processes for deciding on the funding of health services.Henry has over 25 years experience with the Ministry including policy development and planning,information systems/services, issues management, and fee negotiations with providers. He was headof a branch that provided planning, information, financial and other support to the Department’smental health program and led the team that negotiated transfer of this program from the AlbertaHealth and Wellness to the Alberta Mental Health Board. He has graduate degree in the social sciencesfrom the University of Alberta and is a member of Canadian College of Health Services Executives,Institute of Public Administration of Canada, and Health Technology Assessment International (HTAi).[Session 10 April 23 1330 – 1500; Poster presentation April 23 1700 – 1900]

RHONDA BOUDREAU joined the Canadian Agency for Drugs and Technologies in Health (CADTH) inMarch 2004 in the Health Technology Assessment Directorate. Rhonda holds a Master of Arts inExperimental Psychology from Wilfrid Laurier University in Waterloo, Ontario and a Bachelor ofEducation from Lakehead University in Thunder Bay, Ontario. Her prior experience includes working as an Evaluation Consultant for New Brunswick’s Department of Health and Wellness. Rhonda dividesher time as a Research Officer with CADTH working on health technology assessments as well asworking with the Health Technology Inquiry Service (HTIS) to refine research questions with therequestors, and write reports. [Poster presentation April 23 1700 – 1900]

GEORGE BROWMAN has recently moved to BC is a member of the Department of Medical Oncology,BC Cancer Agency, Vancouver Island Centre and a member of the epidemiology research group, BCCancer Research Centre. He is Chair of the Cancer Control Guidelines Action Group of the CanadianPartners against Cancer and adjunct Professor University of Calgary and Professor, Part Time,McMaster University Department of Clinical Epidemiology & Biostatistics (CE&B). Dr. Browman haspreviously served as Professor and Chair, CE&B (1989-97) and Head Department of Oncology,University of Calgary (2004-2006). He has served as President of the Hamilton Regional CancerCentre and Vice President, Cancer Care Ontario (1997-2004) and as Director of the Tom Baker CancerCentre, Vice President Alberta Cancer Board (2004-2006). Dr. Browman was Founding Director ofCancer Care Ontario’s Program in Evidence-based Care and Alberta Cancer Board’s Clinical KnowledgeManagement Resource Team. His main interests are in evidence-based practice, cancer controlguideline development & implementation, and research & knowledge transfer. He practices medicaloncology with a special interest in head and neck cancer treatment and clinical trials. Dr. Browman isa graduate of the McGill Medical School (1971) and received his MSc in Design, Measurement & Evaluationfrom McMaster in 1986. In 2000 he received the O. Harold Warwick Prize from the National CancerInstitute of Canada for his contribution to cancer control in Canada. [Session 4 April 23 1100 – 1230]

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JANICE BUTLER is a Senior Research Officer in the Newfoundland and Labrador Centre for AppliedHealth Research at Memorial University. She is the coordinator of a CADTH-funded project designedto provide contextualized Health Technology Assessment (HTA) research synthesis on a variety ofissues of importance to health policy makers and administrators in the province. Ms. Butler alsocoordinates a capacity-building program to train senior health executives in the development and useof HTA in their decision-making processes in health and community services. The HTA-relatedactivities support her larger role in knowledge transfer and exchange within the provincial ministryand regional health authorities, with the goal of enhancing evidence-informed decision making. Ms.Butler holds master’s degrees in both Nursing and Community Health and Humanities, and her careerhas included extensive experience as an educator and researcher, with a special focus on research andpolicy development for children with asthma and allergies. [Session 1 April 23 1100 – 1230]

STEVEN CARCONE is an alumnus of St. Michael’s College School in Toronto. In 2002, he received aBachelor of Science Honours degree in Kinesiology & Health Science at York University. In 2005,Steven completed a Master of Science in Kinesiology & Health Science at York in biomechanics, whichfocussed on work-related musculoskeletal injuries (low back pain) and seating. Steven is currently aresearcher at the University Health Network (Toronto) in the department of Clinical Decision Makingand Health Care Research. His research interests are in the area of clinical effectiveness, clinicaleconomics, and medical decision-making. Currently, Steven is involved with developing a clinicalpolicy model for prostate cancer, using administrative data to estimate long-term costs in prostatecancer, as well as the application of clinical economic methods to problems of significant importanceto the Canadian health care system. Recently, Steven has expanded his research interests to includehealth technology assessment, where he is presently involved with the evaluation of liquid-basedtechniques for cervical cancer screening. [Poster presentation April 23 1700 – 1900]

BRIAN CARTER holds the position of Director, Public Affairs and Government Relations at IMS Health,Canada where he has been employed since 1997. As a former pharmacy owner and former AssistantRegistrar for the Alberta College of Pharmacists in Edmonton, Alberta, Mr. Carter combines his in-the-field experience with IMS’ market intelligence to meet the information and policy needs of healthprofessional organizations and government agencies across Canada. Mr. Carter holds degrees inBachelor of Science, Pharmacy and Masters of Business Administration from the University of Alberta,Edmonton. [Poster presentation April 23 1700 – 1900]

DONNA CHAMPAGNE has a long and varied nursing career over 30 years in hospitals in Winnipeg andnorthern Manitoba. She also worked as a nursing instructor and a nursing supervisor for over 5 yearsin The Pas. In 2000 she began post-grad studies in Public Administration and became the FacilityDirector of a hospital (Morris), a personal care hospital; and a small juxtaposed hospital and PCH inEmerson. Donna’s most recent position was the Director Community Health Assessment for theCentral Manitoba Regional Health Authority. This project involved research, evidence gathering anddissemination of information on the health status of the community. Donna completed her Bachelorof Nursing in 1999 and her Master of Public Administration in 2004. [Session 6 April 23 1100 – 1230;Session 11 April 24 1030 – 1200]

MICHAEL CHENG works in international development in the fields of health technology and qualitymanagement. He has worked in more than 20 different countries in collaboration with WHO, UNDP,UNFPA, UNICEF, the Asian Development Bank and the World Bank. He was formerly Director of theBiomedical Engineering Department at Ottawa General Hospital and Head of the EnvironmentalControl Technology Department at Vanier College in Montreal. His areas of expertise are: medicaldevice policy and regulations; project monitoring and evaluation; medical equipment planning,equipping, & management; standards and policy and guideline development. He is especially skilledin generating holistic approaches to complex and diverse problems. He earned his Doctorate in


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Biomedical Engineering from McGill University and his Certificate in Healthcare Organization andManagement from the Canadian Healthcare Association. [Pre-symposium workshop April 22 0900 – 1200]

PETER CHINNECK is Director, Partnerships & Strategic Initiatives with the Canadian Agency for Drugsand Technologies in Health. He has worked as a communications professional for more than 26 years.Prior to joining CADTH, he worked for the Government of British Columbia for eight years, includingtwo years as the Executive Director of Communications and Issues Management with the BC Ministryof Health. [Symposium moderator]

JANET COOPER graduated from Dalhousie University's College of Pharmacy. After completing ahospital pharmacy residency, she practiced for 12 years in hospitals in Halifax, Mississauga andOttawa. Janet joined the Canadian Pharmacists Association in 1993. CPhA provides leadership forpharmacists and works to improve medication safety and effectiveness. CPhA is also Canada's largestpublisher of evidence-based drug therapy information. As Senior Director of Professional Affairs, Janetis responsible for CPhA's initiatives in practice development, research, policy, pharmacy humanresources and health informatics. Janet played a lead role in developing e-Therapeutics andfacilitating partnerships with stakeholders. [Poster presentation April 23 1700 – 1900]

RONALD J. CORVARI serves as the Director of Policy and Economics Analysis Branch at the PatentedMedicine Prices Review Board and is responsible for providing strategic research and policy directionon the regulation of drug prices for the benefit of Canadians. Dr. Corvari manages a policy andeconomics staff. In 2003, Dr. Corvari served three years on assignment as the Economic Advisor for theHealth Care and Policy Directorate of Health Canada. In this capacity, he was responsible for directingthe economic analysis and policy development related to Quality Care (including Wait Times) andTechnology. Dr. Corvari also provided leadership on several important issues including Cross-BorderDrug Sales and the Drug Pricing Strategy component of the National Pharmaceutical Strategy. Prior to first joining the PMPRB in 1992, Dr. Corvari served as research economist and analyst with theEconomic Council of Canada, the MacDonald Royal Commission on the Canadian Economy and wasEconomics Instructor at Carleton University. He graduated from Guelph University (B.A. (Hons) inEconomics) and Carleton University (M.A. and Doctorate of Philosophy in Economics - specialization in Industrial Organization and International Economics). [Session 4 April 23 1100 – 1230; Posterpresentation April 23 1700 - 1900]

ANNE-MAXIME DAGENAIS holds the position of Analyst, Public Affairs and Government Relations at IMS Health, Canada. She holds a Bachelor of Science, Biochemistry from McGill University and a Graduate diploma in pharmacy, drug development from the University of Montreal. [Posterpresentation April 23 1700 – 1900]

NEDA DEBASSIGE-TOEG holds degrees in pharmacy (BSP) and medical sociology (BA) from theUniversity of Saskatchewan, and is the first Aboriginal pharmacist from the Northwest Territories.She is a licensed pharmacist in Ontario, Saskatchewan, and the Northwest Territories. A member ofthe M’Chigeeng Ojibway First Nation, Neda was born and raised in Yellowknife and now resides inOttawa. Among Neda’s notable endeavours in the last 10 years was the design of a unique pharmacycourse elective for the University of Saskatchewan. The course, entitled Health Care Practitioners andthe Aboriginal Community – Building Partnerships towards Holistic Healing, addresses theimportance of cultural sensitivity within the health care model and the impact of pervasivestereotypes. In addition to her contributions in health care, Neda has also served as Special Assistantto the Federal Secretary of State for Children and Youth, and in 2005 she undertook a key role inplanning and coordinating the Assembly of First Nations 26th Annual General Assembly inYellowknife. Having relocated to Ottawa, Neda has undertaken the establishment of the AboriginalPharmacists Association of Canada. [Session 5 April 23 1100 – 1230]

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DEIRDRE DEJEAN is a graduate student in the Health Research Methodology Program at McMasterUniversity. She holds a Canada Graduate Scholarship from the Canadian Institutes of Health Research,as well as the Dr John Thomas Award for graduate students studying applied ethics. She is a pastrecipient of an Ontario Graduate Scholarship. Her primary research interests are: ethical dimensionsof health technology assessment, health resource allocation, values in health policy analysis, andmental health policy. Deirdre is a research assistant at the Centre for Health Economics and PolicyAnalysis. She holds a B.A. from McGill University and a B.Sc. from McMaster University. [Posterpresentation April 23 1700 – 1900]

TYRONE DONNON is an assistant professor in the Department of Community Health Sciences and amember of the Medical Education Research Unit at the University of Calgary. His research interestsinclude course and program assessment and evaluation in medical education, approaches to learning,psychometrics, and human development in general. Current research interests have focused on thepredictive validity of medical school admission criteria, assessment in preclinical and clinical medicaleducation, health technology assessment, and the development of psychometric measures ofstudents’ resiliency profile, approaches to learning, and non-intellectual attributes. [Posterpresentation April 23 1700 – 1900]

GREG DUCHSCHERER has been a Respiratory Therapist for over 10 years. He graduated with honoursfrom the Respiratory Therapy program at the University College of the Cariboo (now Thomson RiversUniversity) in British Columbia in 1996. During his training, Greg received numerous awards andscholarships for academic and clinical achievements. Since graduation, he has worked in a number ofacute care centres in both Alberta and British Columbia, where he has demonstrated a keen interestin process improvement and role development while working as a staff therapist, supervisor andClinical Development Specialist (CDS). As the Respiratory Services CDS for the adult ICUs in theCalgary Health Region, Greg is responsible for coordinating the Respiratory Services ICU Supervisorgroup in delivery of evidence-based respiratory care. In addition, he is responsible for representingRespiratory Therapy on a number of multidisciplinary committees within the Calgary Health Region.Recently, he coordinated the initiation of the Respiratory Therapy Professional Practice Committee inCalgary. Greg is also the past chair of the Continuing Competency Committee of Alberta’s RespiratoryTherapy regulatory College, and a scientific reviewer for submissions to the Canadian Journal ofRespiratory Therapy. [Session 8 April 23 1330 – 1500]

STEPHANIE DUENCH is a PhD student at the School of Optometry, University of Waterloo in the area of vision sciences. Stephanie's research involves the physiology of the front surface of the eye, mainlyconjunctival hyperemia, blood flow and oximetry. In conjunction with her thesis work, she has joinedGlaxoSmithKline as and intern in the Department of Statistics and Epidemiology. Her work at GSKfocuses on the microvascular effects of type II diabetes, namely diabetic retinopathy. [Posterpresentation April 23 1700 – 1900]

LESLEY DUNFIELD joined the Canadian Agency for Drugs and Technologies in Health (CADTH) in April2006 as a Research Officer in the Health Technology Assessment Directorate. Lesley obtained her PhDin Pharmacology from Dalhousie University in Halifax, Nova Scotia and then completed a post-doctoral fellowship at the Ottawa Regional Cancer Centre, where she conducted research on ovariancancer. Currently, Lesley works with the Health Technology Inquiry Service (HTIS) at CADTH and haswritten several HTIS reports in addition to her work with health technology assessments. [Posterpresentation April 23 1700 – 1900]


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BRENDALYNN ENS is the Saskatchewan Liaison Officer for the Canadian Agency for Drugs andTechnologies in Health. She has been in this role since September, 2005. Prior to this date, she wasManager of Nursing for the Coronary Care Unit at Royal University Hospital in Saskatoon. Otherexperiences that greatly contribute to her current role at CADTH include 9 years experience teachingcardiovascular/emergency education in all Saskatchewan rural health facilities for the University ofSaskatchewan, College of Medicine, and 18 years experience as a critical care nurse. Brendalynn is alsoa Certified Master Gardener, helping to beautify Saskatoon! [Session 6 April 23 1330 – 1500]

HOLLY ETCHEGARY, PhD, is an interdisciplinary postdoctoral fellow with the GeneSens research group,Department of Epidemiology and Community Medicine, and the Gap-Santé research group, NationalInstitute of Population Health, both at the University of Ottawa. Her research interests include healthrisk perception and communication, health behavior change and genetics health services, particularlygenetic test decisions and genetic risk communication. [Poster presentation April 23 1700 – 1900]

LISA FARRELL is a pharmacist with over 16 years of experience in the health sector. She joined CADTHfrom the Nova Scotia Department of Health, where she was the Coordinator of the Atlantic CommonDrug Review. Lisa has also worked as a Pharmaceutical Industry Representative, a hospitalpharmacist, and a member of the Clinical Initiatives Group at the QEII Health Science Centre inHalifax. Lisa has a Bachelor’s degree in Pharmacy which she completed in 1989. [Session 1 April 23 1100– 1230; Session 6 April 23 1330 - 1500]

PATRICA FORTIN, MLS, MSc, is Project Consultant, Health Technology Assessment for the B.C. ProvincialBlood Coordinating Office. Patricia has an MSc in Health Informatics and has worked as a researcher,data analyst and a project manager on a variety of research projects including clinician acceptance ofinformation systems, electronic health records usability research, knowledge translation in chronicdisease management, physician satisfaction with CDM, pharmaceutical policy projects, anddevelopment of information systems strategy evaluation frameworks, inter alia. Prior to this, Patriciaworked as a library manager and clinical librarian in various health care organizations. [Session 4 April23 1100 – 1230]

KATHRYN GAEBEL is the Senior Projects Manager for the Centre for Evaluation of Medicines, St Joseph’sHealthcare, which is affiliated with McMaster University, and the Manager of the Telephone Group forOutcomes Research (TIGOR). TIGOR collects outcome data using standardized telephone questionnairesfrom patients regarding all facets of healthcare, including but not limited to: drug utilization, druginduced adverse events, healthcare services utilization, disease management and patient satisfaction.A network of community pharmacies in Ontario was established in 1995 to recruit patients for drugutilization studies. The pharmacist obtains the patient’s informed consent when they come into thepharmacy to have a prescription filled for the drug(s) of interest. Data is collected in real-time usingComputer Assisted Telephone Interviewing (CATI) software. Ms. Gaebel received her BSc and MScdegrees from the University of Toronto, and then completed post degree credits in The Health ResearchMethodology Program, at McMaster University. [Session 5 April 23 1100 – 1230]

KIRSTEN GARCES is the Manager for the Health Technology Inquiry Service (HTIS) at the CanadianAgency for Drugs and Technologies in Health (CADTH). A pharmacist by training and a CADTHemployee for more than five years, Kirsten’s work at CADTH has included authoring several healthtechnology assessment reports and emerging technology bulletins. Today, Kirsten oversees HTIS, theHTA directorate’s newest service. Kirsten holds a Bachelor of Science (Chemistry) from the Universityof Ottawa and a Bachelor of Science in Pharmacy from the University of Toronto. She has alsocompleted a pharmacy residency in Managed Care. [Session 13 April 24 1030 – 1200]

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CHANTELLE GARRITTY is Manager of Systematic Reviews at the Chalmers Research Group, Children'sHospital of Eastern Ontario in Ottawa. In addition to being responsible for the overall operationalmanagement of the group, she is also Coordinator of the University of Ottawa’s Evidence-basedPractice Center (UO-EPC). Chantelle has several years of experience coordinating internationalresearch endeavours as Coordinator of the Cochrane Back Review Group, and as Research Coordinatorof the WHO Centre for Neurotrauma Mild Traumatic Brain Injury Task Force Best Evidence Synthesisproject (University of Saskatchewan/Karolinksa Institute). Chantelle is an MSc Candidate in PublicHealth (University of Toronto), has completed graduate studies in Neuropsychological Assessment& Counseling (Institute of Child Study/OISE, University of Toronto), and holds a BA in Psychology(Carleton University). Systematic review methodology, eHealth initiatives, and organizationalbehaviour change are among some of Chantelle’s research interests. [Poster presentation April 231700 – 1900]

KIRSTEN GARTENBURG is a Senior Knowledge Transfer Advisor for Health Technology Assessment(HTA) at the Canadian Agency for Drugs and Technologies in Health (CADTH). Since joining CADTH in 2004, she has initiated a variety of knowledge transfer projects for HTA reports. Prior to joiningCADTH, Kirsten was a senior public relations consultant with inmedia Public Relations Inc. for over sixyears. During that time, she consulted to MDS Nordion’s nuclear medicine unit, Adherex Technologies(a biopharmaceutical company dedicated to the discovery and development of cancer therapeutics),and other biotechnology clients. Kirsten holds a Bachelor of Journalism with Highest Honours fromCarleton University. [Session 11 April 24 1030 – 1200]

MIKE GAUCHER is the Vice-President of Health Technology Assessment (HTA) at the Canadian Agencyfor Drugs and Technologies in Health. Mr. Gaucher joined the organization in 2003 initially workingwith the Common Drug Review. He assumed the role of Vice-President, HTA in May 2004 and isresponsible for managing the HTA directorate, its programs and staff. Mr. Gaucher’s backgroundincludes more than 15 years of experience in hospital pharmacy management, with involvement inplanning, program development and evaluation, policy analysis, research and drug use/formularymanagement. He worked extensively with hospital and provincial drug approval committees, includingnine years on the Formulary Committee of Saskatchewan Health. [Session 10 April 23 1030 – 1200]

SCOTT GAVURA has been Director of Drug Information and Research Centre (DIRC) since 2003. He is responsible for the strategic growth of DIRC as it plays a leading role in enhancing appropriatemedication use in Canada. In this role, Scott is responsible for providing leadership to the DIRC team,and overseeing DIRC’s expanding range of programs, products, and services for health professionalsand the public. Scott’s extensive background in the Canadian health environment has contributed tothe success of DIRC, with a detailed understanding of federal and provincial drug approval andmanagement systems. His former roles include the position of Manager, Drug Submissions, at theOntario Ministry of Health’s Drug Programs Branch. In this position Scott managed the Ontario DrugBenefit submission review and approval process. Scott also held leadership roles and participated onseveral Federal/Provincial/Territorial task groups, including the development of the Common DrugReview as well as work streamlining the generic drug review and approval process. A pharmacist bybackground, Scott has a Bachelor of Science in Pharmacy (BScPhm) from University of Toronto, and anAccredited Canadian Pharmacy Residency (ACPR) from London Health Sciences Centre (LHSC). Hispharmacy experience includes work at both LHSC and Mount Sinai Hospital in Toronto. Scott also hasa Master of Business Administration (MBA) from the University of Toronto. Scott has worked part-time in community pharmacy since graduation and continues to practice regularly at his localpharmacy. [Session 5 April 23 1100 – 1230]


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RON GOEREE received his Masters degrees in Economics from McMaster University. He is currentlyAssistant Professor at McMaster University in the Department of Clinical Epidemiology andBiostatistics, Director for the Program for Assessment of Technology in Health (PATH) and is a facultymember in the Centre for Evaluation of Medicines (CEM) at St. Joseph's Healthcare. Ron is aconsultant for, and has a number of research projects with, both the Ontario Ministry of Health andLong Term Care (MOHLTC) and the Canadian Agency for Drugs and Technologies in Health (CADTH).PATH is an innovative program of research on the evaluation of new and existing health caretechnologies core-funded by the MOHLTC. The value of this research program is that it fosters anevidence-based framework for assessing the value of new health technologies, builds valuable researchpartnerships between users, payers and researchers, and provides the opportunity to demonstrate thepotential for a controlled diffusion of the latest health technologies in Canada. As such, the researchled by PATH represents a novel approach for publicly-funded reimbursement decisions of new healthtechnologies in the Province of Ontario. [Poster presentation April 23 1700 – 1900]

STEPHEN GRAHAM’s role at the Canadian Agency for Drugs and Technologies in Health includesfostering relationships with key stakeholders; creating awareness of and promoting optimal drugtherapy; and working with stakeholders to determine their needs in the areas of interventions. Steveis a pharmacist, holding appointments with the Faculty of Medicine and the College of Pharmacy atDalhousie University. He is a Management Committee Member for the Drug Evaluation Alliance ofNova Scotia and he serves on the Canadian Institutes of Health Research Institute Advisory Board forthe Institute of Aboriginal Peoples Health. [Session 15 April 24 1030 – 1200]

JEREMY GRIMSHAW became the Coordinating Editor for Cochrane Effective Practice and Organisationof Care Group in January 1997 and moved its Editorial base to Ottawa, Canada in January 2002. At thistime, he took up his appointment as Director, Clinical Epidemiology Programme, Ottawa HealthResearch Institute and Head, Centre for Best Practice, Institute of Population Health, University ofOttawa. He is also Professor at the Department of Epidemiology and Community Medicine, Universityof Ottawa and Visiting professor, Centre for Health Services Research, University of Newcastle uponTyne, UK. His research interests include professional behaviour change, implementation research,cluster randomized trials and systematic reviews. Jeremy is also the Director of The CanadianCochrane Network and Centre. [Session 15 April 24 1030 – 1200]

AMANDA HAMMILL is a part-time doctoral student in the Health Research Methodology Program atMcMaster University and a research coordinator for Dr. John Lavis in the Program in Policy DecisionMaking. Understanding how evidence is used by various actors within the policy making process toinfluence social change has been a key area of interest for Amanda Hammill and was the focus of herMaster's thesis in Social Welfare Policy (McMaster University). Her doctoral research is focused on theuse of research knowledge to inform heath human resource policy decision-making. [Session 14 April24 1030 – 1200]

CHRISTA HARSTALL has had a varied career in healthcare from direct patient care as a medicallaboratory technologist to government where she coordinated the initiative to implement a healthtechnology assessment program in Alberta’s Health Ministry in 1988. Christa was responsible for theimplementation of the Health Technology Assessment (HTA) program at the Alberta HeritageFoundation for Medical Research in November 1995. As of July 1, 2006, under the direction of theMinistry of Health, the HTA program merged with the activities of the Institute of Health Economics.

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As the Associate Director of the HTA program, Christa enjoys the challenges of teaching HTA interns,producing relevant and quality HTAs, and encouraging the use of evidence by health care decision makers.She is the Chair of the steering committee for the Research Transfer Network of Alberta. On theinternational scene Christa has contributed to the work of the International Network of Agencies inHealth Technology Assessment through chairing the Ethics Working Group. [Session 8 April 23 1330 – 1500]

MOWAFA HOUSEH is currently finishing his PhD from the University of Victoria, School of HealthInformation Science in the area of technology enabled knowledge translation. Mowafa Househ wasawarded a three year trainee award for his research in this area from the Michael Smith Foundationfor Health Research. Mowafa Househ has an undergraduate degree from the University of Albertafaculty of Business specializing in Management Information Systems and a master of engineeringdegree from the University of Toronto specializing in Health Information Systems. Mowafa Househcurrently works with the Northern Health Authority as a planning and research analyst whilecompleting his doctoral work in technology enabled knowledge translation. Working with theNorthern Health Authority in B.C., Mowafa Househ is applying some of the dissemination techniqueslearnt from his research and applying them in his work environment. Mowafa Househ believes thatas researchers we are accountable to the public for the research that we produce and for it to beeffective it must be relevant, timely, and easily communicated to the intended decision making orpublic audience. [Poster presentation April 23 1700 – 1900]

EMMA IRVIN joined the Institute for Work & Health (then the Workers' Compensation Institute) in1991 to set up and maintain the library. Today she is the manager of the Library, Systems, and thenewly created research program dedicated to conducting Systematic Reviews as well as the convenorfor the Cochrane Library Users Group of the Cochrane Collaboration. Since joining the Institute, shehas managed and contributed to a number of reviews both as a librarian and a reviewer. [Session 3April 23 11:00 – 12:30]

LYNDA JOBIN is Director of CADTH’s Liaison Program and is responsible for a multi-faceted team of Liaison Officers located throughout the country working to strengthen relationships betweenCADTH and Canadian health jurisdictions and increase access to and understanding of evidence-based information to inform health care decisions. Lynda joined the organization in January 2005 as Manager of Program Administration for HTA and assumed the position of Director, Liaison Program in October 2005. Prior to joining CADTH, Lynda had an extensive career with VON Canada, a nationalhealth care organization. A seasoned administrator with over 20 years experience in the health caresector, Lynda has gained significant experience in the areas of strategic & operational planning, projectmanagement, strategic policy development and communications. [Session 6 April 23 1330 – 1500]

HELEN JOHANSEN is a senior analyst with Health Division, Statistics Canada and an adjunct professorat the University of Ottawa. The main goal of her current work is the analysis and publication ofperson-oriented health information based on the linkage of administrative health care, survey andvital statistical data. Research areas include record linkage, utilization of hospital services, projectionof health care needs, cardiovascular disease, high blood pressure, asthma, diabetes and influenzaimmunization. During her career, she has co-ordinated and analysed a national survey on high bloodpressure, acted as a statistical consultant for researchers at the University of Ottawa Heart Institute,and represented Health & Welfare on the Interdepartmental Secretariat on Drug Abuse and on theBoard of Directors of the Canadian Coalition for High Blood Pressure Prevention & Control. She wasa member of the editorial/planning Committees for several joint agency publications including“Diabetes in Canada”, “Respiratory Disease in Canada”, “The Changing Face of Heart and StrokeDisease in Canada” and “The Increasing Burden of Heart and Stroke Disease in Canada“. Helen is acollaborator with the Canadian Cardiovascular Outcomes Research Team (CCORT), and a member ofthe Outcomes Research Task Force of the Canadian Hypertension Education Program. She has a PhD


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in Physical Chemistry from the University of California at Berkeley and she has co-authored morethan 30 peer-reviewed scientific articles, many of them using record linkage. [Poster presentationApril 23 1700 – 1900]

AVA JOHN-BAPTISTE is a doctoral student in the Department of Health Policy, Management &Evaluation at the University of Toronto. The topic of her thesis is “The Cost-effectiveness of treatingHepatitis C virus (HCV) infected persons who are active or recent substance abusers with antiviraltherapy.” Substance abuse is the major mode of transmission of HCV in North America, but very fewactive or recent drug users receive treatment with antiviral therapies. Barriers to treatment includepatient related factors (substance use, mental health disorders), medication related factors (adverseeffects) and system effects (existing practice patterns, inadequate access to drugs). [Posterpresentation April 23 1700 – 1900]

CATHERINE JORDISON is a pharmacy resident with the Ottawa Hospital. She graduated from theUniversity of Alberta in 2006 and made her way to the nation’s capital to consolidate her education.This work represents her residency project, being completed in conjunction with the Canadian Agencyfor Drugs and Technologies in Health, and specifically the Common Drug Review. This is a topic ofspecial interest to Catherine, who is dedicated to the pursuit of evidence-based medicine. [Posterpresentation April 23 1700 – 1900]

CALVIN JOUDRIE is an undergraduate major in Biochemistry and a diploma in Nuclear MedicineTechnology, Dalhousie University and the Victoria General Hospital School of Allied Health in 1985.Mr. Joudrie worked as a Nuclear Medicine Technologist and a Manager of Nuclear Medicine Servicesfrom 1985 to 1994. In 1994 Mr. Joudrie received a diploma in Hospital Management from theCanadian HealthCare Association. Mr. Joudrie held the position of Diagnostic Imaging Manager invarious provinces from 1994 to 2001. Mr. Joudrie was actively involved in various projects toimplement Picture Archiving and Communication Systems in multiple jurisdictions as well as servingon various federal and inter-provincial health and information technology committees. From 2001 to2005, Mr. Joudrie occupied the position of Provincial Diagnostic Imaging Director for the ProvincialHealth Services Authority and the Department of Health, Prince Edward Island. In 2005, theGovernment of Prince Edward Island consolidated its Information Technology Services to form theInformation Technology Shared Services Branch. As part of this transition, the Deputy Minister ofHealth asked Mr. Joudrie to accept a temporary assignment to direct the implementation of keyElectronic Health Record Initiatives. His responsibilities include the Drug Information System Project.[Session 7 April 23 1330 – 1500]

JANET JOY is Director of the Vancouver Coastal Health (VCH) Authority Innovation Program, a programdesigned to integrate traditional technology assessment with organizational self-assessment ofVCH's capacity to implement complex technologies. Much of Dr. Joy's career has been spent bridgingthe world of research and policy, integrating these different types of evidence to inform public policyand organizational decision making. Prior to coming to Vancouver, Dr. Joy worked as a study directorfor 10 years at the National Academies in the U.S., leading projects for both the National ResearchCouncil and the Institute of Medicine. As study director, she co-edited or wrote five major reportsrelating to assessing needs for new technologies and the current status of existing technologies. Shealso wrote on the role of intellectual property policies and practice in research and technologydevelopment. Dr. Joy received her PhD in behavioural neuroscience from University of Toronto, whichwas followed by postdoctoral work at University of Texas and Northwestern University, and 5 years atthe National Institutes of Health (U.S). [Session 12 April 24 1030 – 1200]

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DON JUZWISHIN is an internationally recognized health services/systems consultant with over 25years of experience as an innovative leader in health care delivery, health technology assessment,policy making, reform, policy research, and education. Dr. Juzwishin has led new initiatives in supportof health reform in Alberta, British Columbia and Canada as well as built world class programs ofdelivery in health technology assessment and its use in health care policy making. Dr. Juzwishin isprincipal of Juzwishin Consulting Inc. and an adjunct associate professor at the Universities ofCalgary, Alberta and Victoria. Visit www.IdeasToAction.ca for details. [Session 1 April 23 1100 – 1230;Session 12 April 24 1030 – 1200]

KIERA KEOWN joined the Institute for Work & Health in 2005 as a Knowledge Transfer Associate.Currently she works with several systematic review teams to incorporate and ascertain feedback fromstakeholders. She is also presently contributing to a review in the role of reviewer. [Session 3 April 231100 – 1230]

MURRAY D. KRAHN is a specialist in General Internal Medicine, a Scientist at the University HealthNetwork, and F. Norman Hughes Chair in Pharmacoeconomics at the Leslie Dan Faculty of Pharmacyat the University of Toronto. He is an Associate Professor in the Department of Medicine, HealthPolicy, Management and Evaluation, and the Faculty of Pharmacy. Dr. Krahn completed a Bachelor ofArts in Philosophy at the University of Winnipeg, a medical degree at the University of Manitoba andpost-graduate training in Internal Medicine at the University of Toronto, an MSc in ClinicalEpidemiology at McMaster University and a Research Fellowship in Clinical Decision-Making at theNew England Medical Center. Dr. Krahn's major research interests include the application of decisionanalytic and clinical economic methods to problems of significance to the health system. Recentprojects include development of clinical policy models for prostate cancer and hepatitis C, usingadministrative data to estimate long-term costs, estimating the cost effectiveness of universalhepatitis A and C vaccination in Canada, and studying the application of pharmacoeconomic methodsin provincial formulary committees. [Session 2 April 23 1100 – 1230; Session 9 April 23 1330 – 1500;Poster presentation April 23 1700 – 1900]

KARMELA KRLEZA-JERIC works at the Randomized Controlled Trials (RCT) unit, Canadian Institutes of Health Research (CIHR) in Ottawa, Canada. She is interested in measuring the impact of healthresearch, and developing innovative ways to influence the quality and transparency of clinicalresearch, including the analysis and control of the outcome reporting bias. She led a developmentof CIHR trial database and is managing the registration of trials funded by CIHR. Dr KrleÏa-Jeriç isengaged in trial registration dialogue from local to global levels. She has been leading the OttawaGroup’s dialogue and development of Ottawa Statements. She actively participates in the WHOInternational Clinical Trials Registry Platform (ICRTP) project from its very beginning and is a memberof its Scientific Advisory Group (SAG). Karmela is also a member of the editorial board of the Croatian Medical Journal, CMJ. A graduate of medicine at the Sarajevo University (Bosnia and Herzegovina),Dr KrleÏa-Jeriç holds Masters and Doctorate degrees from Zagreb University (Croatia), and didgraduate and post-doctoral studies at the Columbia University, NY (USA), McGill University andUniversity of Montreal (Canada), respectively. As a public health specialist, she has worked in variouspositions in Croatia, SFR Yugoslavia and in Canada, and was an advisor and consultant to the WorldHealth Organisation (WHO). [Pre-symposium workshop April 22 0900 – 1200; Session 7 April 23 1330 –1500; Session 14 April 24 1030 - 1200]

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HUIMIN LI is a Health Economist for Health Technology Assessment (HTA) at the Canadian Agency forDrugs and Technologies in Health (CADTH). Since joining CADTH in 2003, Huimin has conductedeconomic evaluations and budget impact analyses for a number of HTA reports. Prior to joiningCADTH, Huimin was a research assistant at the Ottawa Health Research Institute where she workedwith pediatric physicians and epidemiologists on their research projects. Huimin holds a MasterDegree of Economics from Carleton University and a Bachelor of International Finance from theHuman University in China. [Poster presentation April 23 1700 – 1900]

LARRY LYND received his BSP in 1986 from the University of Saskatchewan and then completed ahospital pharmacy residency at St. Paul's Hospital in Vancouver. He completed his PhD in the Dept. ofHealth Care and Epidemiology at the University of British Columbia in 2002, receiving funding fromthe Medical Research Council of Canada, Canadian Institutes for Health Research, and the MichaelSmith Foundation for Health Research. He also completed a 2-year post-doctoral fellowship in HealthEconomics with Dr. Bernie O'Brien at McMaster University. He is an Assistant Professor in the Facultyof Pharmaceutical Sciences at UBC, a Scientist at the Centre for Clinical Epidemiology and Evaluation,and has an adjunct appointment to the Dept. of Health Care and Epidemiology, Faculty of Medicine.He holds a Scholar Award from the Michael Smith Foundation for Health Research, is a NewInvestigator of the Canadian Institute for Health Research. Larry is currently the Associate Director ofthe Collaboration for Outcomes Research and Evaluation at UBC and the Health Economics Programat the Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute.He has more the 50 peer-reviewed publications, book chapters, and research abstracts, he sits on theBoard of Directors of the Canadian Association of Population Therapeutics, and is appointed to theNational Drug Scheduling Advisory Committee and the Special Advisory Committee to theRespiratory and Allergy Therapies division of Health Canada. Larry's primary research interests are inthe areas of risk-benefit analysis, pharmacoepidemiology, and health economics. [Poster presentationApril 23 1700 – 1900]

JANET MARTIN is a producer and user of health technology assessment (HTA) in the hospital setting.She has implemented a hospital HTA unit - the High Impact Technology Evaluation Centre (HiTEC) - at the London Health Sciences Centre in London, Ontario, and continues to serve as its Director. Themandate of HiTEC is to perform health technology and policy analyses for decisions of high economic,clinical, or political risk for the hospital. In 2006, Dr Martin was awarded the Medical AdvisoryCommittee award for her work in HTA at the London Health Sciences Centre. In addition to her rolewithin HiTEC, Dr Martin acts as Coordinator, Evidence-based Medicine, Drug KnowledgeManagement, and Clinical Trials in the Department of Pharmacy Services. Dr Martin serves as aMember of the Ontario provincial formulary committee. [Session 2 April 23 1100 – 1230; Session 13April 24 1030 – 1200]

ALAIN MAYHEW joined the EPOC team in May 2004. He is a registered physiotherapist and completeda Masters degree in Epidemiology at the University of Ottawa. Much of his clinical work was in thefield of cardiac rehabilitation, where he first developed an interest in research. He has worked asresearch coordinator in a hospital setting, facilitating research among different health professionals.He has also taught and evaluated students at University of Ottawa, and presented at numerous local,national and international meetings. His research interests include systematic review methods, andadoption of evidence based practices. [Session 15 April 24 1030 – 1200]

MICHELLE McISAAC is a Research Associate at the University of Calgary working on a grant fromAlberta Health and Wellness to provide objective external evidenced-based evaluation of healthtechnologies. Michelle received her BSc in economics from Dalhousie University and her MA ineconomics (focus in health economics) from McMaster University. Michelle has previously workedwith the Technology Assessment Unit of the McGill University Health Centres, and consulted for the

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Conseil du Medicaments (Quebec government). Michelle’s research interests include the economicevaluation of health technologies, pharmacoeconomics, the socio-economic determinants of health,and quality of life research. [Session 13 April 24 1030 – 1200]

PAMELA McLEAN-VEYSEY has practiced hospital pharmacy for over 25 years, working in variouscapacities and specialties. For the past 10 years she has been a Drug Evaluation Pharmacist and is thecurrent Team Leader of the Drug Evaluation Unit at the QE II Health Sciences Centre in Halifax, NS. Inthis role she has become specialized in evidence-based critical appraisal of the medical literature,with a primary focus on drug evaluation reports for Provincial Pharmacare programs in the AtlanticProvinces and the Academic Detailing Program directed by Dalhousie CME. She is current chair of theDrug Evaluation Alliance of Nova Scotia (DEANS) committee and member of the COMPUS expertreview committee on PPIs. [Poster presentation April 23 1700 – 1900]

MARIE-CLAUDE MICHEL received her Pharmacy bachelor degree from Université Laval, Québec City,in 1991. She completed a residency in hospital pharmacy before earning a masters degree in hospitalpharmacy in 1993. She is now an Assistant Clinical Professor at the Faculté de Pharmacie of UniversitéLaval. Since 1993, Mrs Michel has worked as a clinical pharmacist at the CHUQ, a University healthcenter in Québec City. She has been involved in different fields, especially in infectious diseasesclinical practice, research and ambulatory care. She is a permanent member of its Pharmacy andTherapeutics committee. She was invited to join the “Programme de Gestion Thérapeutique desMédicaments” (PGTM) in 2005 and in 2006 became the coordinator of the program at the CHUQ.[Poster presentation April 23 1700 – 1900]

CINDY MOSHER recently joined the CADTH staff after serving 17 years in health care as a manager andclinician in both public and private settings. Cindy graduated from Dalhousie University with aPhysiotherapy degree, after receiving Life Sciences education from Queen’s University. Most recently,in 2002, she completed a Masters degree in Business Administration. [Session 6 April 23 1330 – 1500]

AZHAR NIZAM is a senior associate member in the Department of Biostatistics at Emory University inAtlanta, and a professor of statistical analysis with 18 years of statistical computing experience. Hehas an extensive background in the statistical modelling of infectious disease processes, having actedas principal and co-investigator on numerous studies. He has published widely, and is the co-authorof Applied Regression Analysis and Multivariable Methods, a popular biostatistics text. Azhar holds aMaster’s of Science in Statistics from the University of South Carolina, and an Honours BA inmathematics and economics from Grinnell College, graduating Phi Beta Kappa. [Session 9 April 231330 – 1500]

PETER O’BLENIS has spent the last five years overseeing the design and validation of web enabledtools specifically focused on improving and facilitating the conduct of systematic reviews. He hasworked with over thirty different review groups around the globe comprising more that 650 reviewparticipants and has assembled a collection of proven best practices and methodologies forconducting and delivering electronic systematic reviews (ESRs). Mr. O’Blenis has delivered workshops,training sessions and lectures to systematic review groups and to university students on varioussubjects relating to systematic review methodology. Prior to focusing on systematic reviews, Mr.O'Blenis spent over 15 years in the software industry with his primary focus being large-scaleelectronic data management. He has held management roles with a number of technology firmsincluding Corel, WebGain, The Object People and Oracle Corporation. He is currently retained byTrialStat, a clinical data management firm, where he oversees user requirements and software designfor systematic review and clinical trial management tools. Mr. O’Blenis holds a Bachelor of ComputerScience degree from Carleton University and a Master of Business Administration from Queen’sUniversity. [Pre-symposium workshop April 22 1300 – 1430]


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JOANNE O’GORMAN is the Director of the Office for Health Innovation, Capital Health, Edmonton,Alberta – one of Canada’s largest integrated academic health systems. The Office for HealthInnovation has two key roles: to coordinate the systematic assessment, implementation andevaluation of new health technologies in the region and, to identify and coordinate opportunities for commercialization of innovative technologies with companies, researchers, physicians and staff.Joanne holds a Bachelor’s Degree in Physical Therapy from the University of Alberta. She has over 25years experience working in Alberta and British Columbia in clinical care, health program managementand planning at the provincial and regional levels, and in government health policy and legislationdevelopment. Joanne is a member of Capital Health’s Executive Committee and represents CapitalHealth on Alberta Health’s New Technology Advisory Committee. She has also participated in recentfederal/provincial/territorial health technology consultation and planning initiatives. [Session 1 April23 1100 - 1230]

SANDY PAGOTTO has been the Manager of CDR Drug Reviews since August 2004. As such, she is theprimary contact for industry regarding the status of submissions filed to the Common Drug Review(CDR). Sandy graduated with a BSc in pharmacy from the University of Saskatchewan andsubsequently obtained a hospital pharmacy residency certificate from the Ottawa Hospital – CivicCampus. Following her residency, Sandy specialized in pharmacokinetic drug monitoring andpaediatric oncology at the Children’s Hospital of Eastern Ontario. Next, Sandy became an associateeditor at the Canadian Pharmacist’s Association and, at the same time, maintained her active practicelicense through work at the Ottawa Hospital Rehabilitation Centre. Sandy has worked as a consultanton several health care projects, in particular, the Health Canada Product Monograph GuidanceDocument for Industry. While at the Common Drug Review, Sandy has been instrumental in revisingsubmission guidance to industry, revising report templates, and in developing and implementing apilot project for collaboration with Health Canada and CDR. [Poster presentation April 23 1700 – 1900]

CHRISTINE PERRAS graduated from the University of Toronto with a Bachelor of Science in Pharmacy in1988. She completed a Clinical Residency in Hospital Pharmacy at the Civic Hospital in 1989 and wenton to work as a clinical pharmacist in various Ottawa hospitals. She then held administrative positionswith both Health Canada and Alberta Health and Wellness while completing a Masters of PublicHealth from the University of Alberta in 2003. She has worked for CADTH between 1995 and 1997 andrejoined the organization in 2003 as a research officer in HTA. [Poster presentation April 23 1700 – 1900]

BA' PHAM is a health services research methodologist with Epidemiology and Biostatistics,GlaxoSmithKline Canada, a PhD student in Health Outcomes and Evaluation at the Department ofHealth Policy Management and Evaluation, University of Toronto, a member of the Toronto HealthEconomics and Technology Assessment Centre, University of Toronto and an adjunct member of theChalmers Research Group, Children's Hospital of Eastern Ontario Research Institute in Ottawa. Hisresearch interests include decision analysis, meta-analysis, Bayesian analysis, infectious diseasemodeling, health measurements, and methods in evidence-based medicine. [Poster presentation April23 1700 – 1900]

BETH POTTER is a CIHR-funded postdoctoral fellow in the Department of Epidemiology andCommunity Medicine at the University of Ottawa. Dr. Potter completed her PhD in epidemiology atthe University of Western Ontario in 2003. She has research experience in several areas of appliedpopulation health research, mainly related to social aspects of maternal and child health. She isparticularly interested in the evaluation of population-based screening programs. Her current workfocuses on critically examining approaches to considering ethical, legal, and social issues in healthtechnology assessment, using prenatal and neonatal screening as model technologies. [Posterpresentation April 23 1700 – 1900]

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PAULE POULIN is currently Associate Director of the Office of Surgical Research for the Department ofSurgery and HTA Research Scientist for the Calgary Health Research at the Calgary Health Region,Calgary Alberta. With the help of CADTH/CCOHTA Capacity building grant program, Dr. Poulin hasbeen instrumental in developing a Local HTA Program for the Department of Surgery and otherregional clinical departments within the Calgary Health Region. Dr. Poulin received her doctorate inMedical Physiology (Neuroscience) at the University of Calgary, and pursued a post-doctoralfellowship in the Department of Molecular Pharmacology at the University of Washington, Seattle,USA. She attended a certificate program in Health Informatics from the University of Victoria, BritishColumbia, Canada. She has 9 years experience as a basic scientist, 4 years in Biotechnology and 7years in a regional health authority / hospital environment. [Poster presentation April 23 1700 – 1900;Session 12 April 24 1030 – 1200]

LOREN REIGER is the Program Coordinator for the RxFiles Academic Detailing Program in Saskatchewan.He has guided this program since the initial 1997 pilot project in Saskatoon through to its ongoingexpansion throughout Saskatchewan. He is involved in reviewing and presenting clinical trialevidence as it relates to drug therapy decision making. The RxFiles Drug Comparison Charts havebecome a highly valued tool by physicians and pharmacists across Canada. Loren is extensivelyinvolved in continuing education planning and delivery and serves as a resource for a variety of localand national drug therapy initiatives. He also provides clinical pharmacy consults in painmanagement. [Session 11 April 24 1030 – 1200]

RON ROSENES has been an active member of the HIV/AIDS community in Toronto since 1991. A personliving with HIV since the early days of the epidemic, Ron developed his advocacy skills with The AIDSCommittee of Toronto (ACT), first as Chair of AIDSWalk, then as Board Chair from 1995 to 1998. InSeptember of 1999, he was appointed ACT's first Honorary Director. Ron is a founding Board Memberof the Sherbourne Health Centre and a member of AIDS Action Now! He was a member of theSteering Committee of the Canada AIDS Russia Project. He co-chairs the Community NetworkAdvisory Committee at the Ontario HIV Treatment Network and is a founding Board Member ofAIDS2006 Toronto Local Host which is a co-organizer of the XVI International AIDS conference held in August of 2006. Ron’s awards include: AIDS Committee of Toronto, 10-year Volunteer Award, ACTTop10 Walkers Award, Metropolitan Community Church Hero, Ontario AIDS Network Honour Roll,Queen’s Jubilee Gold Medal, Glen Hillson Award of Excellence. [Session 7 April 23 1330 – 1500]

ANGELA ROCCHI is a co-founder of Axia Research, an organization that specializes in evidence-basedreimbursement for the Canadian pharmaceutical industry. Angela has a pharmacy degree fromUniversity of Toronto and a master’s degree in epidemiology from McGill University, where shefocused on pharmacoepidemiology and pharmacoeconomics. Angela helps pharmaceutical clients to plan reimbursement strategies and to prepare research, economic models and documentationneeded for reimbursement submissions in the Canadian environment. Her interests include thedevelopment of guidelines for economic evaluations and transparency in the reporting of economicevaluations and reimbursement decisions. [Poster presentation April 23 1700 – 1900]

BEATE SANDER is a PhD candidate in the Department of Health Policy, Management and Evaluation at the University of Toronto, Canada, and research fellow in decision-analytic modeling in the Divisionof Clinical Decision Making at the University Health Network Research Institute. Her current researchinterest is in the economic evaluation of health care programs applied to infectious diseases. Herdoctoral research explores the economics of pandemic influenza mitigation strategies and the cost-effectiveness of Ontario’s Universal Influenza Immunization Program. She also serves aspharmacoeconomic reviewer to the Canadian Common Drug Review. Beate Sander is a trained nurse


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and completed a Master’s degree in business administration at Freiberg University, Germany, followedwith the completion of a Master’s degree in Economics of Development at the Australian NationalUniversity, Canberra, Australia. [Session 9 April 23 1330 – 1500; Poster presentation April 23 1700 – 1900]

NANCY SANTESSO is a Registered Dietitian with a Masters in Library and Information Science. She isthe Knowledge Translation Specialist for the Cochrane Effective Practice and Organisation of Care andthe Cochrane Musculoskeletal Groups. Over the past 5 years, Nancy has worked to develop andevaluate dissemination products for consumers, including summaries and decision aids and involveconsumers in the systematic review process. She is also project manager of the Effective Consumerproject: a project to define and measure how consumers effectively participate in and lead theirhealth care. [Poster presentation April 23 1700 – 1900; Session 15 April 24 1030 – 1200]

DON SCHOPFLOCHER was trained as a research Psychologist, obtaining his Ph.D. in psychologicalmeasurement from the University of Alberta. Don joined Alberta Health and Wellness in 1995 and hasworked as a biostatistician for the Health Surveillance Branch since that time. He sits on thePopulation Health Surveys Advisory Committee for Statistics Canada, and manages health surveydata analysis and dissemination for Alberta Health and Wellness. He also analyzes largeadministrative datasets for Surveillance purposes. Don is active in academic research and teaching.He is an adjunct associate professor in the Department of Public Health Sciences at the University ofAlberta, and in the Department of Community Health Sciences at the University of Calgary where heteam teaches a graduate course in Public Health Surveillance. This year Don has been seconded 0.8 toInstitute of Health Economics where he is Director of Research. [Session 10 April 23 1100 – 1230]

JULIE SENÉCAL is the lead on the Clinical Research Initiative at the Canadian Institutes of HealthResearch (CIHR). Mrs. Senécal graduated from Laval University, Faculty of Medicine, M.Sc. in ClinicalEpidemiology (2004). She also holds a business administration degree from Laval University. Prior tojoining the CIHR, was the coordinator of clinical and epidemiological perinatal research units both inQuebec City (at the Centre Hospitalier Universitaire de Québec) and at Montreal's CHU Mère-EnfantSainte-Justine. [Session 14 April 24 1030 – 1200]

JEANNETTE SMITH, who earlier this month marked her second anniversary with CADTH, joined theLiaison Team in January 2007 as the Stakeholder Relations Officer for the Northwest Territories,Nunavut and Yukon. In this role, she provides liaison support to the territories from CADTH’s headoffice in Ottawa. Her former position as CADTH’s Corporate Communications Officer provided herwith a broad understanding of the organization and its role in supporting informed decision making.Jeannette holds an MM from the Eastman School of Music in Rochester, New York and a diploma inPrint Journalism from Algonquin College in Ottawa. A seasoned communications professional, sheworked with the Canadian Council of Professional Engineers and managed media relations forAlgonquin College prior to joining CADTH. She has served on the Board of Directors for the CanadianToy Testing Council and currently sits on the Advisory Committee for the Algonquin Collegeprofessional writing and script writing programs. [Session 6 April 23 1330 – 1500]

STEPHANIE SMITH, a registered nurse, started her career at the Dr. Everett Chalmers Hospital inFredericton. Later, she worked with the New Brunswick Department of Health and CommunityServices as a Public Health Nurse. More recently, she has worked as a Health Promotion Consultantand a Health Care Consultant. She joined CADTH from the Program Analysis and Evaluation Branch ofthe New Brunswick Department of Health and Wellness, where she was an Evaluation Consultant.Stephanie has a Bachelor of Nursing degree as well as an MA (Health Education) degree which shecompleted in 1990. [Session 6 April 23 1330 – 1500]

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ADRIENNE STEVENS is the Education Coordinator at the Canadian Cochrane Network and Centre,located at the University of Ottawa. She obtained her MSc with a focus on developmentalneurogenetics at McMaster University in 2000. She spent five years working in the Department ofClinical Epidemiology and Biostatistics at McMaster University, first as a researcher for ACP JournalClub, Evidence-Based Medicine, Evidence-Based Nursing, and Evidence-Based Mental Health and thenas a methodologist for Cancer Care Ontario’s Program in Evidence-based Care, co-authoring severalsystematic review-based clinical practice guidelines. She was recently the study coordinator for theprofessional and organization of care components of the CADTH COMPUS Interventions Database forPrescribers and Consumers, conducted under the auspices of the Cochrane Effective Practice andOrganisation of Care Review Group. [Session 14 April 24 1030 – 1200]

ALISON SUPINA is a PhD Candidate in Epidemiology, in the Department of Community HealthSciences at the University of Calgary. She is currently in the advanced stages of completing herdissertation work, under the supervision of Dr. Colleen Maxwell. She is also associated with theCentre for Health and Policy Studies and the Institute of Health Economics. She received her Bachelorof Science in Pharmacy and Master of Science in Clinical Epidemiology from the University of Alberta.Ms. Supina’s primary research interests are in Pharmacoepidemiology and Aging, with a particularfocus on mental health, health services, and quality of life. Ms. Supina holds a fulltime studentshipwith Alberta Heritage Foundation for Medical Research. Meanwhile, she continues to practice as acommunity pharmacist. [Poster presentation April 23 1700 – 1900]

AARON TEJANI is a clinical pharmacist and Drug Information/ Clinical Research Coordinator for FraserHealth in British Columbia working on systematic reviews of drug therapy for the hospital formularysystem. In addition to this he works for the Therapetuics Initiative specifically completing systematicreviews of drug therapy for the Drug Assessment Working Group and for Dr. Bassett for the CADTHCapacity Building Grant which involves the PBCO. Dr. Tejani has co-authored a review of rVIIa and itsuse in non-hemphilia bleeding episodes for CADTH. He has authored/co-authored several systematicreviews of drug therapy in the last three years. His duties also include teaching critical appraisal andevidence-based medicine principles to clinicians in Fraser Health. [Session 4 April 23 1100 – 1230]

HLA HLA THEIN is a postdoctoral research fellow at the Division of Clinical Decision-Making & HealthCare Research, Toronto General Hospital, University Health Network and is supported by the BritishColumbia CDC and the National Canadian Research Training Program in Hepatitis C. [Posterpresentation April 23 1700 – 1900]

CHRISTINE THOMPSON is manager of the SEARCH Custom program with SEARCH Canada. SEARCHCustom builds capacity for evidence-informed practice and decisions in Alberta’s health organizationsthrough an array of just-in-time and in-house supports. SEARCH Custom works with healthprofessionals and researchers to build capacity to identify questions, find evidence, develop andconduct research and evaluation projects, and implement evidence-informed changes. Christine’sbackground in health care administration and health promotion has contributed to her current role and interest in capacity building among health professionals. [Session 8 April 23 1330 – 1500]

JOYCE THOMPSON started her career as a Registered Nurse and then as Psychiatric Nurse in PEI. In1972 Joyce joined the PEI Department of Health and Social Services, where she worked in a variety ofpositions starting as a public health nurse to become Regional Director of Queens County PublicHealth Nursing in 1989 and then on to Provincial Director Public Health. Joyce joined the PEI Healthand Community Services Agency as Medical Services Consultant for the Acute Medical ServicesDivision in 1994. Three years later, she returned to the PEI Department of Health and Social Servicesas Acting Director Acute and Continuing Care before moving into the position of Hospital ServicesManager/Insured Programs Manager- a position Joyce has held since 1998. Joyce earned diplomas in


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Nursing and Public Health Nursing and completed a BSc in Nutrition at the University of PEI in 1978.She later obtained a diploma a Business, Public Administration from the University of PEI in 1992before going on to complete her Masters in Science Health Administration in 1995. Joyce was a long-time CCOHTA Board member and at times also simultaneously served as CADTH’s DSACrepresentative for PEI before joining CADTH as PEI Liaison Officer. [Session 6 April 23 1330 – 1500]

ANDREA C. TRICCO is a Research Associate at CRG concurrently pursuing a doctorate in PopulationHealth at the University of Ottawa under the supervision of Dr. David Moher. Her doctoraldissertation focuses on issues surrounding publication bias at the systematic review level. Andreacompleted her Masters of Science (Epidemiology stream) from the University of Toronto in November,2004. For her MSc thesis, she examined work-related traumatic brain injury fatalities. Her thesis wasfunded by both the Ontario Neurotrauma Foundation and the Toronto Rehabilitation Institute. Aportion of her thesis was published in the Brain Injury journal in June 2006. Prior to joining CRG,Andrea participated in a systematic review conducted through the Toronto Rehabilitation Institute.This systematic review, which focused on a treatment plan for workers with mild traumatic braininjury, was published in Brain Injury in October 2005. She has additional systematic review experiencefrom working under the mentorship of Ba’ Pham (an adjunct member of CRG) in the Biomedical DataSciences Department of GlaxoSmithKline, Canada. These systematic reviews focused on 1) diabetes, 2)hepatitis A, 3) mental health, and 4) the use of the Saskatchewan and Manitoba health administrativedatabases to answer research questions. Andrea has peer-reviewed publications related to theepidemiology of brain injury, hepatitis A, and research methodology. [Poster presentation April 231700 – 1900]

WENDY UNGAR is a Senior Scientist in Child Health Evaluative Sciences at the Hospital for SickChildren, Toronto, Canada, an Associate Professor in Health Policy, Management and Evaluation,University of Toronto and an Adjunct Scientist at the Institute for Clinical Evaluative Sciences. Dr.Ungar is the University of Toronto Program Director for the International Masters degree in HealthTechnology Assessment & Management and holds a Canadian Institutes of Health Research NewInvestigator Award. Dr. Ungar leads a program of research in the application of health economicmethods to the paediatric population and this year launched TASK, Technology Assessment at SickKids. TASK is devoted to supporting health economic and HTA methods research in children and toconducting high calibre HTAs to support decision-making at the hospital for Sick Children. [Session 12April 24 1030 – 1200]

ANN VOSILLA, CADTH’s BC Liaison Officer, is a Registered Nurse and practicing member of the Collegeof Registered Nurses of BC with a strong clinical background spanning 21 years. She also holds anAdvanced Specialty Certificate in Forensic Science Technology, Forensic Crime Studies from the BritishColumbia Institute of Technology. Prior to joining CADTH, Ann spent 134 years in Medical and ClinicalServices departments within the Pharmaceutical Industry. Her focus was safety protocol adherenceand compliance monitoring in order to reduce mortality rates of individuals registered in specificmedication programs. [Session 6 April 23 1330 – 1500]

JIM WINNICK has over 25 years of management experience in single and multi-facility settings withinthe Calgary Health Region including, Respiratory Therapy, Pulmonary Diagnostics, Cardiodiagnosticsand Neurodiagnostics. Over the past 10 years, Jim was also responsible for the shifting of resources,personnel and the integration of services during two hospital closures in Calgary. During this time, hehas successfully coordinated the regionalization of Respiratory Services within the adult care centres.Jim continues to play an active role on many committees and professional associations at provincialand national level, in addition to holding the past-president position with the College and Associationof Respiratory Therapists of Alberta and the Canadian Society of Respiratory Therapists. As regional

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manager for the Respiratory Services department in the Calgary Health Region, Jim is responsible forover 200 staff on three sites. He manages all aspects of Respiratory Services and PulmonaryDiagnostics for the Adult Acute Care Hospitals within the Calgary Health Region including ongoingmajor and minor equipment evaluation and selection, all staffing functions and capital planning. Hehas a keen interest in promoting evidence based practice with a particular focus on critical carerespiratory therapy. [Session 8 April 23 1330 – 1500]

AMY WONG is Research Associate, Evaluation, Analysis, and Information Services with the AlbertaHeritage Foundation for Medical Research. She has a Bachelor of Commerce and is currentlycompleting a Masters of Public Health (Health Policy and Management). She has conductedevaluations and surveys for a range of AHFMR departments and programs, among them healthtechnology assessment, communications, and grants and awards. [Session 11 April 24 1030 – 1200]

A B S T R A C T SConcurrent Sessions Monday A.M. April 23rd

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Putting HTA into Practice: Challenges and Solutions

Panel Chair: Michael Allen, Dalhousie University

1100 – 1230 Session # 1 Richelieu

Panelists: Janice Butler, Newfoundland and Labrador Centre for Applied Health Research; Lisa FarrellCanadian Agency for Drugs and Technologies in Health; Don Juzwishin, Juzwishin Consulting; JoanneO’Gorman, Capital Health

Producing health technology assessment (HTA) reports is now a well developed process with standardmethods of literature search, critical appraisal, statistical analysis, and reporting of results. Howeverputting the findings of HTA reports into practice is much more problematic. Many factors may affect theimplementation of HTA reports: the influence of clinical practice guidelines which may contradict thereport; the lack of awareness of HTA among physicians and decision-makers; the difficulty of relating thereport to local conditions, capacities, and resources; varying capacity to routinely look at evidence beforedecision making; and external pressures that are applied to adopt technology.

In this session, panel members will briefly present their ideas about the challenges of putting HTA intopractice in a range of contexts and jurisdictions. They will then engage the audience in discussion toobtain their perspectives on strategies they have found successful and to identify further solutions.

Equity, Ethics and Resource Allocation

Moderator: Christa Harstall, Associate Director, Health Technology Assessment, Institute of HealthEconomics

1100 – 1230 Session # 2 Victoria

A Strategy to Improve Priority SettingPresenter: Douglas K. Martin, University of Toronto Joint Centre for Bioethics

Three Scientific Paradigms in Health Technology Assessment: Experiences of the Committee to EvaluateDrugs in OntarioPresenter: Murray Krahn, Toronto General Hospital, University of Toronto, University Health Network

Waking the SLEEPERs: Using “Know4Go” to Incorporate Social, Legal, Ethical, and Political Dimensionsinto Health Technology Decision Making Presenter: Janet Martin, HiTEC, London Health Sciences Centre


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A Strategy to Improve Priority SettingPresenter: Douglas K. Martin, University of Toronto Joint Centre for Bioethics

Priority setting is arguably the most important health policy issue of our time because no health system,whether primarily publicly funded (e.g. UK, Canada) or privately funded (e.g. USA, Tanzania), can affordto provide every service it may wish to provide. Skyrocketing costs, particularly of new healthtechnologies including drugs, are challenging policy makers and administrators to maintain quality andsimultaneously control spending. The sustainability of health systems everywhere is at risk.

Recent initiatives to improve priority setting by focusing on information and tools -- e.g. evidence-basedmedicine and cost-effectiveness analysis -- have not made the task easier because, at the core, prioritysetting involves making complex choices among competing relevant values and decision makers lackguidance for resolving these value-based conflicts.

Two key goals in a strategy to improve priority setting are fair process -- which provides much neededlegitimacy to these important public policy decisions, and an evidence-base for priority setting -- that is,a database of learning that captures and shares good practices and opportunities for improving prioritysetting.

In this paper, the strategy will be described using illustrative examples from a decade of collaborativescholarship in actual decision making contexts within the health system.

Three Scientific Paradigms in Health Technology Assessment: Experiences of the Committee toEvaluate Drugs in OntarioPresenter: Murray Krahn, Toronto General Hospital, University of Toronto, University Health NetworkCo-authors: Chaim Bell, Scott Berry, Bill Evans, Nancy Lum-Wilson

Background:The Cancer Subcommittee of the Ontario Committee to Evaluate Drugs is charged with theresponsibility to decide which cancer drugs in Ontario will be funded under the New Drug FundingProgram.Methods:Decision making in the committee is evolving along three scientific paradigms. Evidence Based Medicine(I) has been and is a part of decision making through rigorous evidence reviews and the implicit rulethat drugs must pass the threshold of effectiveness to be funded. Health economic criteria (II) are beingincreasingly implemented through tougher reviews, pharmacoeconomic education of committeemembers, establishment of a pharmacoeconomics unit, and evolving cost effectiveness thresholds. Theprocess (as opposed to decision criteria) of decision making is evolving using the ethical foundations ofAccountability for Reasonableness (III), important tenets of which are transparency, accountability, andstakeholder involvement in the decision process.Conclusion:Each scientific paradigm comes from a distinct intellectual tradition. We believe that optimal decisionmaking for cancer drugs involves integrating concepts from each tradition.


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Waking the SLEEPERs: Using “Know4Go” to Incorporate Social, Legal, Ethical, and Political Dimensionsinto Health Technology Decision Making Presenter: Janet Martin, HiTEC, London Health Sciences Centre

Health technology assessment (HTA) has been berated for its overly narrow and technical approach todecision-making.While it is true that many technology assessments have given preferential focus totechnical aspects such as clinical evidence and economic information, there is increasing recognition thatexpanded domains of influence on decision-making must be explored within HTA. Despite this increasedawareness, there have been few formal attempts to explicitly incorporate social, legal, ethical,environmental, political, and entrepreneurial (SLEEPER) issues into decisions in real-time. Know4Go providesan approach to objectively consider the impact of SLEEPERs alongside clinical and economic evidence inorder to comprehensively inform technology uptake at the decision-maker table. The Know4Go strategyapplied to decision-making for recent decisions in our hospital will be given as examples.

Stakeholder Involvement within the Institute for Work and Health Systematic Review ProgramWorkshop Lead: Kiera Keown, Institute for Work and Health

1100 – 1230 Session # 3 Chaudière

Co-Presenter: Emma Irvin, Institute for Work and HealthCo-Authors: Emma Irvin, Dwayne Van Eerd

Objective:To describe the benefits and challenges of involving stakeholders into the systematic review process.

This interactive workshop will address the rationale for involving stakeholders in a systematic review. Thegroup will discuss the identification and engagement of stakeholders to provide feedback for reviews. Inthe course of the workshop we will present information about various models the IWH has used toengage stakeholders (including policymakers, healthcare practitioners, health and safety professionals)during various steps of a systematic review including: topic selection, defining the research question,refining the search terms, reviewing the literature, extracting messages for dissemination. The benefitsand challenges of the various models of involvement will be discussed. Different strategies to engage thegroups of stakeholders will be presented. The interactive nature of the workshop will allow participants toshare their experiences in stakeholder engagement and potential models they have employed.

Blood, Cancer, Drug Utilization: New Tools for Policy MakersModerator: Brendalynn Ens, Canadian Agency for Drugs and Technologies in Health

1100 – 1230 Session # 4 Frontenac

A New Tool for Fair Decisions for Cancer Drug FundingPresenter: George Browman, BC Cancer Agency

Building Capacity: Using Evidence in Utilization Management of Immune Globulin Therapy Presenter: Aaron Tejani, Therapeutics Initiative, University of British Columbia

National Prescription Drug Utilization Information System (NPDUIS)Presenter: Ron Corvari, Patented Medicine Prices Review Board


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A New Tool for Fair Decisions for Cancer Drug FundingPresenter: George Browman, BC Cancer AgencyCo-authors: Carole Chambers, Neil Hagen, Braden Manns, Shane Sinclair

Purpose:Design a tool to assist with cancer drug funding decisions.Background:Policy-makers are struggling with funding decisions about expensive cancer drugs. Centralized drugreview, although important, needs regional input to consider unique priorities. We were asked to designa system to rank new cancer drugs for regional funding decisions. Method: The 'Accountability forReasonableness' framework informed design of a six module multi-stakeholder decision processblending evidence-based ‘technology assessment’ with individual and cultural ‘values elicitation’.

The tool was piloted in three settings:(i) videotaped simulated multi-stakeholder deliberations;(ii) oncologists;(iii) provincial Pharmacy & Therapeutics committee.

The modules involve:1) decision clarification;2) eligibility filtering;3) clinical scoring index;4) cost modeling;5) values clarification; and 6) process evaluation.

Results:The tool was feasible to use, acceptable to participants and was able to rank candidate drugs.Conclusion:The tool can complement centralized review processes to facilitate local cancer drug funding decisions.

Building Capacity: Using Evidence in Utilization Management of Immune Globulin Therapy Presenter: Aaron Tejani, Therapeutics Initiative, University of British ColumbiaCo-presenters: Patricia Fortin, BC Blood Coordinating OfficeCo-authors: Patricia Fortin, Aaron Tejani

Background:Provincial governments globally fund the blood system with little consideration of evidence regardingefficacy or cost. The (BC) Provincial Blood Coordinating Office (PBCO) aims to incorporate best evidenceinto its existing utilization management activities with the help of the UBC Therapeutics Initiative (TI) anda CADTH grant.Methods:The PBCO and the TI are producing systematic reviews (SRs) of blood products, including intravenousimmune globulin (IVIG). IVIG is used for approximately 70 medical conditions in BC, costing $23million/year and a mean of $16,000/patient). A decision-making framework will be developed tosupport IVIG use only if a therapeutic advantage is established for specific indications, based on SRfindings. Baseline and program evaluation data will be gathered by the PBCO.Results:Several IVIG reviews have been produced for use in the new decision-making framework. Systematicreview findings, policy options and IVIG utilization data will be presented.


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Policy Implications:The evidence-based decision-making framework and systematic review findings are relevant to otherprovincial/territorial funding agencies in Canada and elsewhere.

National Prescription Drug Utilization Information System (NPDUIS)Presenter: Ron Corvari, Patented Medicine Prices Review Board

The National Prescription Drug Utilization Information System (NPDUIS) was established in September2001 to provide critical analyses of price, utilization and cost trends.

The goal of NPDUIS is to provide timely information to support the effective management of Canada'spublic drug programs. The Patented Medicine Prices Review Board (PMPRB) and the Canadian Institutefor Health Information (CIHI) work collaboratively to develop and maintain NPDUIS.

The PMPRB has initiated a number of projects that are intended to support informed decision-making.

In addition to providing analyses of trends in drug expenditures, price levels, per-unit costs and drugutilization, Budget Impact Guidelines are being developed to assist drug plans in estimating thefinancial impact of listing new drug as benefits. The New Drug Pipeline Monitor will identify drugswhich are in the latter phases of research and have potential to be important therapeutically. Amethodology to forecast drug expenditures is also being developed.

Drug Therapy Decisions: Processes, Impacts, Implications

Moderator: Susan Groves, Chair, Federal Drug Benefits Committee, Canadian Forces PharmacistsMaintenance of Competency Program

1100 – 1230 Session # 5 Joliet

Development of Health Technology Assessment skills in a Drug Information CentrePresenter: Scott Gavura, Drug Information and Research Centre, Ontario Pharmacists' Association

Impact of the Implementation of COMPUS PPI MessagesPresenter: Denis Bélanger, Canadian Agency for Drugs and Technologies in Health

A Therapeutic Substitution Policy for Proton Pump Inhibitors: Aboriginal patients Burden of IllnessPresenter: Neda Debassige-Toeg, Aboriginal Pharmacists Association of Canada

Development of Health Technology Assessment skills in a Drug Information CentrePresenter: Scott Gavura, Drug Information and Research Centre, Ontario Pharmacists' AssociationCo-authors: James Bowen, Ron Goeree, Jean-Eric Tarride

Integration of HTA information into drug therapy decision-making by front line health care professionalsdoes not occur routinely.The Ontario Pharmacists’ Association Drug Information and Research Centre (DIRC)identified the need to enhance its skills at assessing and interpreting HTAs so that information could beincorporated into its telephone inquiries and publications.The Program for Assessment of Technology inHealth Centre for Evaluation of Medicines served as an HTA mentor organization to DIRC, delivering a seriesof training modules. Each module consisted of a live presentation at DIRC with group discussions.


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Presentations and discussions were digitally recorded for training of new staff. DIRC mentor pharmacistsreceived additional training at CEM/PATH.The project built HTA capacity in DIRC and the ability to undertakenew projects and services.The learnings and application from this collaboration will be presented.

Impact of the Implementation of COMPUS PPI MessagesPresenter: Denis Bélanger, Canadian Agency for Drugs and Technologies in HealthCo-authors: Stephen Graham, Sumeet Singh

Implementation of key messages developed by CADTH through COMPUS will have a positive impact onthe prescribing and utilization of Proton Pump Inhibitors (PPIs).

COMPUS has developed and applied a process to identify the gaps between what we know (from evidence)and what occurs when prescribing drugs. The first COMPUS drug topic was PPIs. Clinical evidence wasreviewed by members of an Expert Review Panel and evidence-based statements were developed andendorsed. Patterns of current utilization were identified and compared to the Panel statements, outlininggaps related to the use of PPIs. For example, in 55% of cases family physicians prescribe the two most costlyPPIs as initial therapy for the management of uninvestigated gastroesophageal reflux disease (GERD) anddyspepsia Evidence shows that for initial therapy, all PPI’s produce similar results which generally meanslesser expensive PPI’s could be used with no impact on health outcomes.

Uptake and adoption of key messages developed by COMPUS will significantly impact the initialselection and dose of PPIs for common gastrointestinal conditions managed by family physicians. In2004, family physicians prescribed 80 percent of the 12.4 million PPI prescriptions in Canada.

A Therapeutic Substitution Policy for Proton Pump Inhibitors: Aboriginal patients Burden of IllnessPresenter: Neda Debassige-Toeg, Aboriginal Pharmacists Association of Canada Co-presenter: Kathryn Gaebel, Centre for Evaluation of Medicines (CEM), St Joseph’s Healthcare, HamiltonCo-authors: Kathryn Gaebel, Mitchell Levine

Proton pump inhibitors (PPIs) can vary greatly in price but it is thought that there is very little variationin clinical effects.

Health Canada’s Non-Insured Health Benefits (NIHB) Program, instituted a therapeutic substitutionpolicy for PPIs as a cost containment strategy.

Objective:To determine the effect of this cost containment strategy on First Nations and Inuit people in northernisolated communities.Method:Five pharmacies in the Northwest Territories (NT) identified and consented patients who then received astandardized interview with a pharmacist.Results:42 of 66 patients from 11 northern communities were interviewed. 35 (83%) reported problems after therequired switch to a less expensive PPI. Problems were severe enough to send 18 (51%) to nursingstations and 7 (20%) to the ER, which required Medivac.Conclusions:Majority of patients experienced problems possibly associated with lack of efficacy and adverse drugreactions. Further analyses will determine whether the costs associated with the patient reportedproblems and resultant healthcare service use exceeded drug cost savings derived from the policy.

A B S T R A C T SConcurrent Sessions Monday P.M. April 23rd

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Partnerships from Coast to Coast – CADTH’s Liaison ProgramWorkshop Lead: Lynda Jobin, Canadian Agency for Drugs and Technologies in Health


Co-Presenters: Donna Champagne, Brendalynn Ens, Lisa Farrell, Cindy Mosher, Jeannette Smith,Stephanie Smith, Joyce Thompson, Ann VosillaCo-Authors: Lisa Farrell, Jeannette Smith, Sheila Tucker, Ann Vosilla

The Liaison Program was established in 2004 to strengthen relationships between CADTH andCanadian health jurisdictions. Liaison Officers increase access to and understanding of evidence-based information to inform health care policy and practice decisions. This session will provide aninteractive forum to increase understanding of the Program, its activities and future directions. Thepanel, comprised of Liaison Officers and the Program Director, will provide a description of theprogram and how it has been implemented across the country as an innovative approach tosupporting health decisions. Using a case study approach, each Liaison Officer will discuss how theprogram is meeting its objectives by:

1) responding to local needs and circumstances;2) providing evidence-based health technology information to support health care decisions;3) building the capacity to understand and use HTA;4) supporting local delivery of CADTH programs and services;5) facilitating the timeliness and relevance of CADTH products.

New Data Sources: Trial Registration, Post-Approval Surveillance and Data WarehousesModerator: Ian McKillop, Executive Director, Health Research, University of Waterloo

1330 – 1500 Session # 7 Richelieu

PEI Drug Information System - Data WarehousePresenter: Calvin Joudrie, Island Health Information System

Trial Registration as a Tool of Decision Making, Providing Evidence for Adoption of New Drugs andDevices and Strengthening People’s Trust; Canadian Institutes of Health Research (CIHR) and GlobalPerspectivePresenter: Karmela KrleÏa-Jeriç, Canadian Institutes of Health Research

Evidence-Based Formulary Listing Decisions: The Need for an Improved Post-Approval Surveillance SystemPresenter: Ron Rosenes, Canadian Treatment Action Council


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PEI Drug Information System - Data WarehousePresenter: Calvin Joudrie, Island Health Information System

Prince Edward Island will implement a Drug Information System (DIS) in 2007 that will captureinformation on all prescription medications dispensed to all residents of the Province. The DIS willprovide pharmacists, physicians, and other health care professionals with comprehensive electronicmedication profiles to enhance the delivery of health care and management of drug therapies. Theproject also includes the creation of a robust data warehouse which will support health planning,evaluation, and approved research. The data warehouse will generate reports in five categories:operational, managerial, system adoption/usage, research, and security. PEI has received funding forthis project from Canada Health Infoway, whose mandate is to foster and accelerate the developmentand adoption of electronic health information systems in Canada.

Trial Registration as a Tool of Decision Making, Providing Evidence for Adoption of New Drugs andDevices and Strengthening People’s Trust; Canadian Institutes of Health Research (CIHR) and GlobalPerspectivePresenter: Karmela KrleÏa-Jeriç, Canadian Institutes of Health ResearchCo-Author: Isabelle Schmid

The process of adoption of new drugs and devices includes the evaluation of the process of theirdevelopment. In this evaluation it is essential to have trustworthy and transparent evidence gainedby research. A prospective registration of trials on humans and public disclosure of their results are aprerequisite of ethical and scientific conduct of research and of a trust in their results.

Besides continuing to promote trial registration in Canada, CIHR has been actively involved indeveloping international standards, mainly through a dialogue of the Ottawa Group and the WHOtrial registration project.

An update will be given with a particular emphasis on the International standards for registration ofall human medical research launched by the WHO in May 2005 as well as the vision of disclosure ofresults proposed in the Ottawa Statement part 3.

Evidence-Based Formulary Listing Decisions: The Need for an Improved Post-Approval SurveillanceSystemPresenter: Ron Rosenes, Canadian Treatment Action CouncilCo-author: Louise Binder, Patrick Cupido

Public drug plan managers require reliable data on adverse drug reactions (ADRs) in makingformulary listing decisions, whether on initial review or re-review. The well-documentedunderreporting of ADRs in the current Canadian post-approval surveillance system (PASS) constitutesa barrier to informed decision making.

The Canadian Treatment Action Council (CTAC) has noted unfavorable listing decisions on new HIVantiretroviral therapies (ARTs) where there was insufficient ADR data to distinguish them frompreviously listed therapies.

CTAC conducted its PASS study to address the need for more ADR information on ARTs, by testing anumber of community-based ADR reporting methods. The results of the PASS study and subsequent


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community consultations demonstrated the willingness of people living with HIV/AIDS to reportADRs and the sentinel role that community-based organizations could play in an improved PASS.Findings from the PASS study could enhance ADR information available to policy makers for evidence-based formulary listing decisions.

Collaboration for HTA at the Front Line: The Case of Inhaled Nitric Oxide (iNO) in the Management ofAcute Lung Injury/Acute Respiratory Distress SyndromePanel Chair: Greg Duchscherer, Calgary Health Region


Panelists: Christa Harstall. Institute of Health Economics; Christine Thompson, SEARCH Canada; JimWinnick, Calgary Health RegionCo-Authors: Bing Guo, Christa Harstall, Robert Hayward

In keeping with their commitment to high-quality care, the Calgary Health Region (CHR) RespiratoryServices Department sponsored their Clinical Development Specialist as a participant in SEARCHClassic. In this intensive two year program, staff from health organizations, are mentored by academicfaculty to build capacity to “use”, “choose” and “create” evidence for application to practice, policy andservice delivery. In this case, a tenfold increase in costs coupled with uncertain clinical benefits,prompted the need for an evidence-based policy regarding inhaled Nitric Oxide therapy for adultswith acute respiratory failure. Through a collaboration between CHR, the Institute of HealthEconomics, and SEARCH Canada, the Specialist completed a Health Technology Assessment to addressthis issue. During the panel presentation, the partners in this project will discuss the effectiveness ofthis collaboration both in terms of addressing a local need and in creating ongoing capacity tosupport evidence-based practice.

Health Economics: Equity, Impact Evaluation and Other ConsiderationsModerator: Karen Lee, Manager Health Economics, Canadian Agency for Drugs and Technologies inHealth


Methodological Issues in Cost-Effectiveness Evaluation of Targeted Versus Universal Hepatitis AVaccination in Canada Presenter: Chris Bauch, University of Guelph

Economic Evaluation of Influenza Pandemic Mitigation Strategies in the US Using a StochasticMicrosimulation Influenza Model Presenter: Beate Sander, Toronto General Hospital, University of Toronto, University Health Network

What Needs Adjustment in Cost-Effectiveness Analysis to Capture Equity Concerns?Presenter: Ahmed Bayoumi, Centre for Research on Inner City Health, St. Michael's Hospital, Toronto


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Methodological Issues in Cost-Effectiveness Evaluation of Targeted Versus Universal Hepatitis AVaccination in Canada Presenter: Chris Bauch, University of GuelphCo-authors: Andrea Anonychuk, Bernard Duval, Vladimir Gilca, Murray Krahn, Ba' Pham

Background:Herd immunity, under-reporting in case notification data, and cohort effects are rarely accounted forin cost-effectiveness evaluation of infectious disease control programs.Objectives:To compare universal HA vaccination (currently recommended in US) to targeted vaccination(currently recommended in Canada).Methods:A dynamic model taking into account herd immunity was used in a cost-utility analysis with 2005-C$costs, 5%-discounting rate, 80-year timeframe, and a ministry perspective. Under-reporting wasadjusted for by systematically reconciling prevalence and cumulative reported incidence data; and acohort effect by reconstructing the history of transmissibility over the past century in Canada.Results:Universal HA vaccination with a combined HA/HB vaccine in a school-based setting with phasing outtarget vaccination was cost-effective at a threshold of $50,000/QALY, with a mean net benefits of 3.8QALYs (SD=3.0).

Economic Evaluation of Influenza Pandemic Mitigation Strategies in the US Using a StochasticMicrosimulation Influenza Model Presenter: Beate Sander, Toronto General Hospital, University of Toronto, University Health NetworkCo-presenter: Azhar Nizam, Emory UniversityCo-authors: Lou Garrison Jr., Elizabeth Halloran, Ira Longini Jr., Maarten Postma

Objectives:To project the potential impact of pandemic influenza mitigation strategies on health outcome, cost,and cost-effectiveness from a societal perspective.Methods:We use a stochastic agent-based model to simulate pandemic influenza in the community. Wecompare 17 strategies, focusing on targeted antiviral prophylaxis (TAP) with oseltamivir alone and incombination with school closure.Results:In the absence of intervention, we predict a 50% attack rate with an economic impact of $187 percapita. TAP, the most effective single strategy prevents 54% of cases at $120 per capita. TAP+schoolclosure and pre- vaccination+school closure (preventing 94-96% of cases at $2,730 per capita) arecomparable in terms of QALY gain and total costs. The ICER compared to TAP is $50,500/QALY foreither strategy. If vaccine is available then pre-vaccination prevents 48% of cases at $99 per capita.Conclusions:Targeted antiviral prophylaxis is an effective and cost-saving measure for mitigating pandemicinfluenza.


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What Needs Adjustment in Cost-Effectiveness Analysis to Capture Equity Concerns?Presenter: Ahmed Bayoumi, Centre for Research on Inner City Health, St. Michael's Hospital, TorontoCo-authors: Jeffrey Hoch

Cost-effectiveness analysis (CEA) compares the ratio of incremental costs and effects (E) to themaximal societal willingness to pay ( ). To address a major limitation of CEA, the neglect of equity,some have proposed adjusting E, most commonly by incorporating equity weights into qualityadjusted life year estimates.

However, this approach sacrifices transparency by conflating three factors, each of which a decisionmaker might want to explicitly value and consider (survival, quality of life, and equity). Wedemonstrate how equity concerns can be captured by adjusting (not E), using the net benefitframework. The ratio of equity-adjusted values of E between two alternatives (or a new and areference intervention) is equivalent to the scaling factor for and requires minimal assumptionsabout the form of the equity-weighting functions. We provide a worked example using the results ofa conjoint analysis study of equity preference weights.

HTA and Health Policy: Recent Developments Across CanadaModerator: Don Juzwishin, Juzwishin Consulting


Health Policy & Technology Assessment: Recent Developments in AlbertaPresenter: Henry Borowski, Alberta Health and WellnessCo-presenters: Don Juzwishin, Juzwishin Consulting; Donald Schopflocher, Institute of Health Economics

Recent developments in Alberta relating to health technology assessment (HTA) and policy withemphasis on the strategic plan to enhance the Alberta HTA model and work to effectively incorporateevidence into health policy will be discussed. In 2006/07 responsibility for the provincial HTA functionmoved from the Alberta Heritage Foundation for Medical Research to the Institute of HealthEconomics (IHE); IHE and Alberta Health and Wellness completed the strategic plan for an enhancedAlberta HTA model; Government released Getting on with Better Health Care, its policy framework,committing to the increased of use scientific evidence in health policy decision-making; AlbertaHealth Technologies Decision Process continued to help build capacity and inform Ministry decisionsthrough completed provincial reviews of health technologies (e.g. Alberta - first province to introduceNewborn CF Screening), and IHE hosted Canada’s first Consensus Development Conference (Self-Monitoring for Diabetes).

HTA and Health Policy Developments in QuebecPresenter: Reiner Banken, Agence d'évaluation des technologies et des modes d'intervention en santé

The Health Technology Strategy Policy ForumPresenter: Mike Gaucher, Canadian Agency for Drugs and Technologies in Health


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Knowledge Transfer and ExchangeModerator: Craig Larsen, Director, Knowledge Transfer, Canadian Agency for Drugs and Technologies inHealth


Academic Detailing Plus: The Benefits of Academic Detailing Beyond Clinician EducationPresenter: Michael Allen, Dalhousie CME

Knowledge Translation of HTAs for Policy Makers Presenter: Donna Angus, Alberta Heritage Foundation for Medical Research

Engaging Decision Makers in HTA Research: Lessons Learned from the Knowledge Transfer of CADTH’sEmergency Department Overcrowding HTA Presenter: Kirsten Gartenburg, Canadian Agency for Drugs and Technologies in Health

Academic Detailing Plus: The Benefits of Academic Detailing Beyond Clinician EducationPresenter: Michael Allen, Dalhousie CMECo-presenter: Loren Regier, The RxFiles - Academic Detailing ProgramCo-authors: Shawn Bugden, Diane Duncan, Richard Morrow, Anne Nguyen

Academic detailing is the provision of evidence-based information to health providers in theirpractice settings via one-to-one visits by trained educators, usually pharmacists. Academic detailingprograms from five provinces (BC, AB, SK, MB, NS) have formed the Canadian Academic DetailingCollaboration to make academic detailing more efficient and effective. While there is evidence thatacademic detailing is effective in changing clinician behaviour and improving patient outcomes, thispresentation will review the contributions of academic detailing beyond its role in educatingphysicians. As examples, the academic detailing programs have:• developed symposia and workshops on HTA;• contributed to guidelines on cardiac care and other clinical areas;• educated medical students;• produced a drug comparison chart book;• pioneered the use of technology to provide academic detailing;• contributed to development of evaluation methods for other educational and drug policies;• informed physicians about clinical programs in regional health authorities; and• developed tool kits for the Canadian Optimal Medication Prescribing and Utilization Service.

A B S T R A C T SConcurrent Sessions Tuesday A.M. April 24th


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Knowledge Translation of HTAs for Policy Makers Presenter: Donna Angus, Alberta Heritage Foundation for Medical ResearchCo-presenter: Amy Wong, Alberta Heritage Foundation for Medical ResearchCo-authors: Christa Harstall, Richard Thornley

Objective:To present information, distilled from health technology assessments, of relevance to policy andhealth service decision makers.Method:A draft summary was developed and presented to selected government officials. Suggestions wereincorporated and five Executive Briefing Notes were produced and distributed to Canadian andinternational decision makers. One hundred recipients were surveyed to determine the relevance,credibility, understandability, and usefulness of the briefing notes.Results:Twenty-eight individuals responded to the survey. Ninety-three per cent said the briefs were relevantor somewhat relevant; 86% said they were credible; 82% said they were useful or somewhat useful.The majority of respondents found the reading level, amount of detail, and format appropriate andeasy to understand.Conclusion:Indications are that the Executive Briefing Notes have value as a tool to inform decision makers aboutHTA results. Valuable information was gathered from the survey to improve dissemination of reportsand summaries.

Engaging Decision Makers in HTA Research: Lessons Learned from the Knowledge Transfer of CADTH’sEmergency Department Overcrowding HTA Presenter: Kirsten Gartenburg, Canadian Agency for Drugs and Technologies in HealthCo-presenter: Donna Champagne, Canadian Agency for Drugs and Technologies in Health

Find out how CADTH developed and implemented a multi-faceted knowledge transfer strategy for itsrecent Emergency Department Overcrowding HTA series –- the first national, comprehensive study ofthis issue.

The goal of the knowledge transfer strategy was to engage Canadian policy makers, hospital and EDadministrators, and health care researchers in the evidence on Emergency Department Overcrowdingin the reports.

Knowledge transfer activities included a Research Highlights tool with messaging for variousaudiences groups, web conferences, teleconferences and meetings, as well as media relations. Allmajor tactics were evaluated. Those interested in learning how knowledge transfer strategies canhelp put research results in the hands of policy makers and health care professionals, are invited to attend.


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Evidence-based Decision Making on the Front LinesModerator: Kenneth Baird, Vice President, Clinical and Facility Support Services, Atlantic Health Sciences

1030 – 1200 Session 12 Richelieu

The Alberta Regional Health Technology Assessment DemonstrationPresenter: Don Juzwishin, Juzwishin Consulting

Technology Assessment at Sick Kids (TASK): A Model for a Health Technology Assessment Unit in aPediatric Tertiary Care and Research CentrePresenter: Wendy Ungar, Hospital for Sick Children, Toronto

Adapting a Local Health Technology Decision Support Program to Various Departments within aHealth RegionPresenter: Paule Poulin, Foothills Medical Centre, Calgary Health Region

Evidence Based Technology Purchasing? Successes and Challenges in Improving the Use of Evidence inHealth Technology Decision MakingPresenter: Ellen Balka, Simon Fraser University, Vancouver Coastal Health

The Alberta Regional Health Technology Assessment DemonstrationPresenter: Don Juzwishin, Juzwishin ConsultingCo-authors: Edith Amend, Jon Brehaut, Laurel Stretch

Introduction and Purpose:The purpose of the Alberta Regional HTA demonstration project, funded by the CADTH 2006 CapacityBuilding Grants, is to assist Alberta’s non-metropolitan health authorities to implement or, whereprocesses already exist improve, evidence – informed decision making regarding the acquisition ofhealth technologies.Discussion:The first part of the presentation will focus on identifying and describing the challenges and issuesfacing the non-metro health regions in adopting an evidence-informed approach to policy anddecision-making surrounding the effective use of health technology assessments. Some of theprimary barriers to using HTA in non-metro health regions are identified and described.Conclusion:The second part of the presentation will describe how the research project had to be “nimble on itsfeet” in order to respond to the immediate needs and serve the requirements of the non-metrohealth regions. Strategies and mechanisms for preserving and maintaining the project objectives aredescribed.

Technology Assessment at Sick Kids (TASK): A Model for a Health Technology Assessment Unit in aPediatric Tertiary Care and Research CentrePresenter: Wendy Ungar, Hospital for Sick Children, Toronto

At the Hospital for Sick Children, there has been a growing interest in Health Technology Assessment(HTA) of new technologies, both from an institutional perspective, with the hospital increasinglyfacing challenging purchasing decisions, and from a researcher’s perspective, as an opportunity todevelop and evaluate new methodologies. The purpose in establishing TASK (Technology Assessmentat Sick Kids), an HTA research unit, is to create opportunities for sharing of knowledge and resources,


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stimulate research and training devoted to HTA in children and conduct meaningful assessments toinform hospital allocation decisions. The value of TASK will be demonstrated through pilot projectsthat examined the cost-effectiveness of image-guided therapy versus operating room insertion ofport catheters in children with cancer and the cost-effectiveness of omitting a chest radiograph in thediagnosis of bronchiolitis in the Emergency Department. TASK may benefit all Canadian paediatrichospitals and positively impact HTA research in children.

Adapting a Local Health Technology Decision Support Program to Various Departments within aHealth RegionPresenter: Paule Poulin, Foothills Medical Centre, Calgary Health RegionCo-authors: Elijah Dixon, Rene Lafreniere, Catherine M. Scott, Cam Waddell

Local decision-makers need good tools and processes to introduce new drugs, treatments, or devicesfor their local context. To address this, the Department of Surgery from the Calgary Health Regiondeveloped a Local HTA Decision Support Program. However, the program should be consistently usedby all departments within a health region. For this, we are now adapting the Department of SurgeryLocal HTA Decision Support Program to other selected departments. Each department has received aprogram review package; is currently testing and revising the program; and will makerecommendations for improvement. Recommendations will be compiled and discussed at a jointretreat, and a final Local HTA Decision Support Program package will be created. This process isdesigned to engage clinicians and administrators in creating a flexible and dynamic decision supporttool that can be used by management in individual departments and across the Region whendeciding on new health technologies.

Evidence Based Technology Purchasing? Successes and Challenges in Improving the Use of Evidence inHealth Technology Decision MakingPresenter: Ellen Balka, Simon Fraser University, Vancouver Coastal HealthCo-presenter: Janet Joy, Vancouver Coastal Health

Although health technology assessment activities are gaining currency in Canada, it has been arguedthat new forms of assessment are required, and that assessment activities must more adequatelymeet organizational and policy makers’ needs. In this paper we reflect on successes achieved throughresearcher-health authority collaboration in health technology assessment. Collaborations haveincluded field based evaluation of information technologies, and meeting pre-purchase needs forevidence about technologies under consideration for purchase. In spite of successes, we have alsoencountered some challenges as we have worked to institutionalize health technology assessmentactivities. Challenges have included limited resources dedicated to preparing knowledge synthesisand difficulties associated with coordinating activities across a large distributed organization. Despitecurrent commitment to evidence based decision making, there remains an under-developed capacityto apply evidence critically and systematically – especially in the many technology purchasingdecisions that are made outside of the usual domain of health technology assessment.


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Challenging Policy Issues: Expensive Drugs for Rare Diseases, Pandemic Influenza, AssistedReproductive TechnologiesModerator: Tammy Clifford, Director Project Quality, HTA, Canadian Agency for Drugs and Technologiesin Health


Review of Issues Associated with Assisted Reproductive Technologies (ARTs) and PreimplantationGenetic Diagnosis (PGD)Presenter: Michelle McIsaac, Foothills Medical Centre, University of Calgary

An Example of the Health Technology Inquiry Service (HTIS) Supporting National Decision Making:Antiviral Prophylaxis for Pandemic InfluenzaPresenter: Kirsten Garces, Canadian Agency for Drugs and Technologies in Health

Expensive Drugs for Rare Diseases: Stories from the Coal-FacePresenter: Janet Martin, HiTEC, London Health Sciences Centre

Review of Issues Associated with Assisted Reproductive Technologies (ARTs) and PreimplantationGenetic Diagnosis (PGD)Presenter: Michelle McIsaac, Foothills Medical Centre, University of CalgaryCo-authors: Sandra Berzins, Robert Lee

Recently the Alberta provincial government has been asked to consider funding assisted reproductivetechnologies (ARTs) and preimplantation genetic diagnosis (PGD). This rapid review was conducted toinform the Alberta Health Technologies Decision Process regarding the wide variety of issuesassociated with potential funding alternatives. Many of these issues are beyond the scope ofconventional health technology assessment (HTA), and are not readily quantifiable. Nonetheless,decision makers require awareness of these issues for evidence based decision making. This reviewcovers the efficacy, effectiveness, safety, cost and cost-effectiveness, as well as the legal, ethical, andsocial implications of funding ARTs and PGDs. International and national guidelines, regulations, andfunding statuses are also examined. This review has helped to inform decision makers regarding thecomplexity of publicly funding ARTs and PGD. It also demonstrates an example of a comprehensivefirst-line HTA that addresses a wide spectrum of relevant decision making criteria.

An Example of the Health Technology Inquiry Service (HTIS) Supporting National Decision Making:Antiviral Prophylaxis for Pandemic InfluenzaPresenter: Kirsten Garces, Canadian Agency for Drugs and Technologies in Health

In an influenza pandemic setting, it is unlikely a vaccine would be available immediately. Thus, oralantiviral agents may represent an option for preventing influenza. The current Canadian PandemicInfluenza Plan provides antivirals for the prophylaxis and treatment of influenza in priority groups.Canada is currently reviewing the prophylaxis aspect of the plan.

HTIS was contacted by the Public Health Agency of Canada (PHAC) to conduct a review of theevidence to inform national policy recommendations on the appropriate use of the national antiviralstockpile. HTIS worked closely with the requestor to refine the research question and ensure thattheir information needs were met. HTIS prepared a series of reports investigating the evidencesurrounding the efficacy, harm and cost-effectiveness of several different durations of prophylaxis


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with oseltamivir, zanamivir and amantadine in several patient populations to help guide decision-makers on the role of these drugs within the context of influenza pandemic planning. An oralpresentation on the report findings was also provided to the requestor to complement the report,enhance the understanding of the evidence and its limitations, and offer an opportunity for questions.

These reports were finalized for the PHAC in time to advise the Public Health Network council whichultimately provides recommendations to the Federal/Provincial/Territorial Ministers of Health who willset the national policy. While the Canadian Pandemic Influenza Plan with respect to antiviralprophylaxis has not yet been updated, this presentation will describe the how the HTIS reports wereused to support decision making and the changes to the plan resulting from the information provided.

Expensive Drugs for Rare Diseases: Stories from the Coal-FacePresenter: Janet Martin, HiTEC, London Health Sciences Centre

A number of expensive drugs for rare diseases (EDRD) have entered the market and many more areon the horizon, yet there has been no agreement on a pan-Canadian strategy for EDRD decision-making. As a result, decisions are being made piecemeal at the provincial level and at the hospitallevel. A number of formidable challenges have stymied decision-makers, and questions are escalatedfrom the front lines (Can we ethically say no to an eligible patient?), to the hospital administrators(How can we pay for this from a fixed budget with many tangible competing interests? Whoseresponsibility is it to pay?), to the government policy makers (How can we ensure an appropriatebalance between accessibility and cost-effectiveness? Which is the more laudable aim - equity in drugcoverage or equity in health outcomes?). The realities of decision making for EDRD will be discussedusing recent examples from the hospital and government settings.

Engaging StakeholdersModerator: Heather Bennett, Manager Optimal Practice, COMPUS, Canadian Agency for Drugs andTechnologies in Health


Expanding stakeholder involvement to improve understanding and use of Cochrane reviewsPresenter: Cheryl Arratoon, The Canadian Cochrane Network and Centre

Best Practice Patient Engagement Framework for Decision MakersPresenter: Katharina Kovacs Burns, University of Alberta & Best Medicines Coalition

Partnership for Clinical Research: CIHR Clinical Research InitiativePresenter: Julie Senécal, Canadian Institutes for Health Research

Expanding stakeholder involvement to improve understanding and use of Cochrane reviewsPresenter: Cheryl Arratoon, The Canadian Cochrane Network and CentreCo-presenters: Amanda Hammill, McMaster University; Adrienne Stevens, The Canadian CochraneNetwork and Centre

Knowledge transfer and exchange activities will only lead to more effective health services andimproved health if they are based upon the best available evidence. Seen as the ‘gold standard’ ofsystematic reviews of effects, Cochrane reviews are a source of credible evidence about clinical (and


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increasingly policy) interventions. This session will describe the ‘push', ‘facilitating pull’ and ‘exchange’models being used to improve the dissemination and use of Cochrane reviews in Canada. Pushactivities include partnering with health professional associations to identify relevant Cochranereviews and strategically disseminating digests of the reviews to their members. Facilitating pullactivities include making available an online searchable database of “friendly front ends” forsystematic reviews, and developing capacity to use reviews through targeted education and trainingactivities. Exchange activities include working in partnership with Cochrane’s consumer network andwith a stakeholder group comprised of representatives from Cochrane’s core target audiences.

Best Practice Patient Engagement Framework for Decision MakersPresenter: Katharina Kovacs Burns, University of Alberta & Best Medicines Coalition

When patients and consumers of health care express an interest in being actively and meaningfullyengaged in discussions concerning healthcare decisions and policies, decision makers should takeadvantage of their offers to participate. Patient/consumer participation has been increasing resultingin both good and negative experiences. In a recent Canada-wide study, perspectives of patients,consumers, and others were obtained. Over 400 survey participants and 64 dialogue participantsindicated their commitment and enthusiasm to actively take part in the healthcare policy decision-making process as opposed to being viewed as the problem or cause of increasing healthexpenditures. The results also justified the creation of a Framework for decision-makers on how toengage patients and consumers in policy decision-making processes. This included not only the what,how, why, when and to what extent, but also the best approaches for ‘engaging’ them and bestmethods for patient/consumer capacity building to prepare them to participate.

Partnership for Clinical Research: CIHR Clinical Research InitiativePresenter: Julie Senécal, Canadian Institutes for Health ResearchCo-presenter: Karmela KrleÏa-Jeriç, Canadian Institutes for Health ResearchCo-authors: Karmela KrleÏa-Jeriç, Peter Liu

CIHR is, jointly with its partners, working on the strengthening of clinical research in Canada byinvesting in clinician-researchers, clinical research resources, and the operating costs of clinicalresearch. A stronger clinical research enterprise will accelerate the translation of clinical researchdiscoveries into improved and cost-effective approaches to maintaining health and treating illness,and to provide evidence for sound health policies and an efficient health care system.

The broad spectrum of partners included in this process will ensure that the research based evidenceis used more efficiently in the process of adoption and use of drugs, devices, other technologies, andhealth care practices.

In this presentation, we will present CIHR’s strategies, partnerships, and programs such as ClinicalResearch Networks and Centers and other clinical research related programs.


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Interventions to facilitate evidence-based prescribing and drug use: Evidence to inform policy decisionmakingPanel Chair: Jeremy Grimshaw, Ottawa Health Research Institute


Panelists: Stephen Graham, Canadian Agency for Drugs and Technologies in Health; Alain Mayhew, TheCanadian Cochrane Network and Centre; Nancy Santesso, The Canadian Cochrane Network and Centre

Evidence about the effects of drugs and health technologies is one of the primary elements in healthcare decision making at a policy level. It follows that evidence about interventions to promoteevidence-based prescribing and use of those effective drugs and health technologies should also beused to inform those decisions. Review evidence for these interventions has been systematicallysearched, appraised, analyzed and summarised by the Cochrane Effective Practice and Organisation ofCare and the Consumers and Communication Review Groups. The panel will present the followingwith time for discussion.1. A description of the methods used to collect, evaluate and summarize information from existing

systematic reviews.2. A summary of the findings of interventions targeting professionals and prescribing behaviour

and the gaps in the evidence.3. A summary of the findings of interventions targeting patients and drug use and the gaps in the

evidence.


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An Assessment of the Clinical Evidence in Economic Evaluations Submitted to the Common DrugReview (CDR)Catherine Jordison

The clinical information used in economic evaluations should be of good quality and be relativelyunbiased; however, this may not always be the case.

Objective:To identify the source and assess the quality of clinical information used in manufacturer-submittedeconomic evaluations to the CDR, when clinical claims differ from the conclusions of CDR systematic review.Methods:For each submission to the CDR between 2003 and 2005, it was determined if the safety and efficacyconclusions of the CDR systematic review differed from those in the economic submission. If so, theclinical data sources used in manufacturer-submitted economic evaluation were identified and thequality of the information was assessed using standardized tools appropriate for the design of thestudies. The differences were categorized using previously published criteria.Results:Forty-nine submissions were made to the CDR between 2003 and 2005. These are currently beingevaluated and results will be available by March 2007.Conclusion:The results of this study will be used to provide additional guidance to the developers of economicevaluations regarding the use of appropriate clinical inputs.

Burden of Human Papillomavirus Infection across Canada: A Systematic Review Ba’ Pham

Background:Data on burden of HPV infection is needed for primary (e.g., vaccines) and secondary (e.g., liquid-based cytology) prevention evaluation.Objectives:To systematically review studies reporting cervical HPV prevalence and associated risk factors amongCanadian participants.Methods:29 studies were included from MEDLINE and EMBASE searches (n=307), back- referencing, and authorsearch. Data abstraction was done by 2 reviewers.Results:Across 5 provinces, high risk oncogenic HPV prevalence was 14% in ages <19y, 8-24% in 20-24y, 6-17%in 25-39y, 5-10% in 35-44y, 2-6% in 40-49y and 3-9% in 50-59y and 2-12% in 60+y. Ratio of high:low riskHPV was 2.13 (range 1.47-3.62). HPV prevalence by cytology was: normal 6-30%, ASCUS 20-30%, LSIL

P O S T E R P R E S E N T A T I O NA B S T R A C T S


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≥70%, HSIL ≥ 90%, and cancer 70-94%. Most frequently detected genotype and reported risk factorwas HPV-16 (4.7-13.0%) and number of sexual partners respectively.Conclusion:The burden of HPV infection, including possibly persistent infection (e.g., 1-13% in ages >30) is high.

Clinical Evidence Available for Expensive Drugs for Rare Diseases: Challenges for ReimbursementRecommendationsSandy Pagotto

The Common Drug Review (CDR) has reviewed and released final recommendations for severalexpensive drugs for rare diseases.

Objective:Identify challenges in making reimbursement recommendations for expensive drugs for rare diseases.Methods:Data abstracted for 4 drugs from the CDR reviews and CEDAC final recommendations.Results:All of the drugs received a CEDAC recommendation of “do not list”. In total, 6 double blindrandomized controlled trials and 2 controlled clinical trials (CCTs) were considered. All trials received aquality rating of acceptable using appropriate standardized tools. Issues identified in the CEDACrecommendation were: length of the trials (3/4); results based on surrogate outcomes (3/4), no trialdata to assess clinically meaningful outcomes (3/4), CCTs reported on only a subgroup of patients(2/4). All drugs had small target populations (50-300 Canadians). The costs ranged from $100,000 to$900,000/patient per year.Summary:While the quality of the trials (internal validity) was moderate to high, there were challenges relatedto the clinical trial information identified in the CEDAC recommendation. The clinical trial uncertainty,also limits the assessment of cost effectiveness.

The Concurrent Use of Cholinesterase Inhibitors and Anticholinergic Medications in Patients withAlzheimer's Disease: Comparison of Alberta and SaskatchewanAlison Supina

In SK and AB, coverage for cholinesterase inhibitors (ChEIs) is provided for AD patients under specialauthorization programs. Besides meeting clinical criteria, SK requires no concurrent use of moderateto severe anticholinergic agents. We compared the use of anticholinergic drugs in AD patientsreceiving a cholinesterase inhibitor in AB and SK and examined correlates of contraindicated druguse. Analyses were based on linked administrative data for those with an index (first) prescription fora ChEI during the first year of program coverage. Patients with a claim for a selected anticholinergicmedication within 90 days after index date were considered to be users. Approximately 6.4% (SK) and10.1% (AB) of AD patients received 1+ claim(s) for an anticholinergic. Multivariable analyses show asignificantly increased risk for use of 1+ anticholinergic(s) among females, SK patients in nursinghomes and AB patients residing in rural communities (p <0.05). Differences in special authorizationapproval criteria regarding use of contraindicated medications may be effective for reducingconcurrent prescribing, following initiation of approved therapy.


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The Cost-Effectiveness of Nucleic Acid Amplification Testing in the Detection of Acute Hepatitis C VirusInfectionHla Hla Thein

Early identification of acute hepatitis C virus (HCV) infections is important for individual and policyimplications. We evaluated the cost-effectiveness of adding pooled nucleic acid amplification testing(pooled NAT) to conventional testing with enzyme immunosorbent assay in detecting acute HCVcases in an adult population screened for HCV. A Markov cohort model was constructed to estimatethe lifetime cost-effectiveness of the two screening strategies from a Canadian health care payer’sperspective, taking into account preventive measures and treatment for new infections. Parameterestimates were obtained from the BC provincial laboratory, which performs all HCV tests for BCpopulation, and from the published literature. Compared to conventional testing, the pooled NATinclusive strategy would identify 10/100,000 additional cases of acute HCV infection/annum, with anincremental cost-effectiveness ratio of ~48.6 million Canadian dollars per QALY gained.

Preliminary results suggest that the pooled NAT inclusive strategy has value in detecting acute HCVinfections but not cost-effective using conventional cost-effectiveness thresholds.

Cost-effectiveness of Long-term Management of HeartburnRon Goeree

Background:The optimal strategy for managing heartburn i.e., intermittent or continuous maintenance H2-receptor antagonist (H2RA) or proton pump inhibitor (PPI), step-down maintenance H2RA, and on-demand PPI is controversial. Although PPIs are considered superior to H2RAs, they represent a higheracquisition cost.Objectives:To compare the expected costs and outcomes of primary care strategies for managing moderate tosevere heartburn over 1-year.Methods:A decision-analytic model was developed to estimate costs and effects for various strategies forheartburn. Meta analyses were conducted to synthesize outcome data (symptomatic relief andrelapse) from randomized controlled trials. Uncertainty was assessed using probabilistic sensitivityanalysis.Results:Continuous PPI therapy is the most cost-effective strategy based on “willingness to pay” (WTP) valuesabove $92,000/QALY. For WTP between $6,000 and $92,000/QALY, “on-demand” PPI strategy is mostcost-effective.Conclusion:The optimal strategy for managing patients with moderate to severe heartburn is dependent on theQALY WTP.


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Demographic and Clinical Predictors of Quality of Life in Prostate Cancer PatientsMurray Krahn

Purpose:To determine predictors of quality of life in prostate cancer (PC) patients.Methods:We derived a population-based sample of PC patients from the Ontario Cancer Registry (n=1531).Consenting survivors completed demographic and quality of life questionnaires (n=670), and chartswere reviewed (n=546).Results:Mean age was 72.6 years. Mean Functional Assessment of Cancer Therapy-Prostate (FACT-P) score was127.3, mean Health Utilities Index (HUI3) utility was 0.86, and mean Patient Oriented Prostate CancerUtility (PORPUS-Ui) was 0.86.Comorbidity (Charlson >2), age, and lower education were associatedwith lower scores (all p<0.01). Only PORPUS-Ui was significantly lower in patients with metastases(n=16) than without (n=530). Among patients who received surgery or radiation, with or withouthormone treatment, FACT-P and PORPUS-Ui were highest for radical prostatectomy. External beamradiation was associated with the lowest scores.Conclusions:Age, education, comorbidity and treatment predicted quality of life in PC patients.

Developing Criteria and Decision-Making Processes for Prioritization of Health Technologies at theLocal LevelPaule Poulin

Whereas increasing numbers of local decision-makers are using health technology assessments (HTA)for deciding whether a technology should be considered for adoption, most do not have well definedtools to determine what needs to be considered around a technology’s funding or purchase. Wepropose to develop and test a prioritization tool that will assist local decision-makers in ranking anddeciding among various health technologies for funding or purchase. To do this we will use aconsultative method and 1) compile a list of prioritization criteria and decision-making models from the literature,2) work with local decision-makers to determine which prioritization criteria and decision-making

model best meet their needs,3) test this new prioritization tool in selected departments within the Calgary Health Region, and4) incorporate the revised prioritization tool into our Local HTA Decision Support Program. This project

will enhance knowledge transfer and exchange of HTA into clinical practice.

Development of an Undergraduate Level University Course and a 1-Day Workshop on the Principles ofHealth Economics and HTA to Increase Health Practitioner KnowledgeLarry Lynd

As part of the CADTH Capacity Building program, we developed the first 3-credit, 39 contact-hour,undergraduate-level university course in Health Technology Assessment and a one-day workshop,both aimed at health care professionals. The primary objective was to improve practitionerunderstanding of HTA, economic analysis, and their applications to health care policy making. Coursecontent was developed: 1) by reviewing all available HTA conference short-courses and graduatecourse syllabi; and 2) a 1-day brainstorming, roundtable meeting of HTA experts. Course contentincludes components of HTA and policy making, types of HTA, introduction to epidemiology, health


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economics, and methods of economic evaluation. To date, the class has been offered in 3 terms to 36students from various healthcare and commerce disciplines. The course has been rated very highly interms of development of critical thinking (4.4/5), evaluation (4.3/5) and scientific inquiry skills (4.2/5),and overall (4.3/5). A 1-day workshop is now being offered to pharmacists.

Drug Evaluation Unit: A Structure to Support Evidence-based Policy Decisions and EducationalInterventionsPamela McLean-Veysey

The Drug Evaluation Unit (DEU) provides support to the Atlantic Common Drug Review formularydecision-making process by providing evidence-based written and oral presentations of a drug’ssafety, efficacy and cost-effectiveness. The expertise in critical appraisal and knowledge of specializeddrug topics are valuable assets that aide in the provision of on-going support to the AtlanticProvinces for the implementation and administration of policy decisions. On a national level, DEUpharmacists were in consultation with CADTH in the developmental stages of the CDR and currentlyprovide support to the local CEDAC member.

The relationships built between the DEU, policy makers, national bodies, expert opinion leaders andacademia have provided a structure to work collaboratively, and share knowledge efficiently in otherevidence-based educational interventions designed to influence practice. As examples, the DEUcollaborates with the Drug Evaluation Alliance of Nova Scotia (DEANS), the Dalhousie CME AcademicDetailing Program, the National Academic Detailing Collaboration, continuing pharmacy educationand researchers at Dalhousie University. DEU pharmacists are consulting with COMPUS on the currentPPI and diabetes initiatives.

e-Therapeutics Drug Therapy Decision ToolsJanet Cooper

e-Therapeutics is a new online decision-support tool that delivers current, evidence-based Canadiandrug and therapeutic information at the point of care. Development was funded in part throughHealth Canada’s Primary Health Care Transition Fund. Delivered through a web portal, with somecontent on a handheld, e-Therapeutics is a centralized resource offering drug monographs, diseaseand symptom management, new drug safety information, a drug interaction analyzer and links topublic drug plans, references and patient information. It has been built to integrate with Canada'selectronic health record applications. e-Therapeutics aims to support best practices in medicationmanagement and to improve safety and cost effectiveness by providing busy practitioners withaccess to the right information at the right time to make the right therapeutic decision. The HealthCouncil of Canada has urged adoption to improve prescribing and prevent adverse events. Ongoingevaluation includes practitioner feedback on how e-Therapeutics influences decision making.

Ethics in Canadian Health Technology Assessment: A Descriptive ReviewDeidre DeJean

Despite the mandate to examine the medical, social, ethical, and economic implications of thedevelopment and use of health technology, HTA reports often emphasize the epidemiologic andeconomic aspects, and omit ethical considerations. This study examines how ethical issues are


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incorporated into HTA when they are addressed. What sorts of ethical issues are addressed? Whatstrategies are used for including ethical issues in HTA?

This project is a descriptive review of ethical issues in Canadian HTA reports published from 1997-2006. We characterize the sorts of ethical issues that are addressed, both explicitly and implicitly. Weexamine the strategies used to gather and synthesize ethically relevant evidence. Using an existingframework for the ethical assessment of health technologies, we note the strengths anddiscrepancies in the ethical analysis of health technologies in practice. Finally, we offerrecommendations for when and how ethical considerations can be more successfully incorporatedinto HTA.

Expansion of Universal Newborn Screening for Inborn Errors in Metabolism and Cystic Fibrosis: AnEvidence Informed Approach used in Canadian ProvinceHenry Borowski

Report on evidence-informed reviews of universal newborn metabolic and cystic fibrosis screeningand their results. Pressure to expand the Alberta’s screening program stems from technologicalchange, decisions in other provinces, and clinician-public advocacy. A review under the Alberta HealthTechnologies Decision Process (government’s process for deciding on funding of health services) wascompleted. It married concepts from HTA and epidemiology. Evidence relating to the case forscreening for a condition rather than the effectiveness of the technology was important. ModifiedJunger-Wilson screening criteria and expert opinion were used to develop the recommended list ofconditions for the Minister of Health’s consideration along with economic assessments of MCAD andCF and broad consultation on a synthesis report of the findings. In September 2006, the Ministerannounced that Alberta would expand its metabolic screening program (3 to 16 conditions), becomefirst province in Canada to introduce CF screening, and provide additional funding.

Interactive HTA Education Program for Health Care Practitioners in a Local Residency ProgramTyrone Donnon

Evidence-based medicine has been supportive of the residents’ role as the medical expert. However, itis the HTA approach to local research and decision-/policy-making initiatives that extends this role tointegrate all seven of the Royal College of Physicians and Surgeons of Canada’s (RCPSC) CanMEDS corecompetencies. The principal objectives of this education initiative were to: (1) engage and educateResidents and Directors about HTA methods; (2) enhance their understanding of HTA practices byrelating them to the seven CanMEDS core competencies, and (3) facilitate the integration of formalHTA protocols for Residency-in-Training Programs.

The results are presented in terms of a general template for conducting HTA, to assist participants inmaking sound health-care decisions/policies. This education initiative provides Residents in Training,Directors, and Division/Department Representatives with a unique opportunity to fulfill RCPSCexpectations, and emphasizes the practical benefits of employing HTA in both their research andfuture clinical endeavors.


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Lay Perceptions of Genetic TestingHolly Etchegary

The new genetics raise complex social and ethical questions with which publics and policymakersmust grapple. The complexity of issues has prompted calls for greater public debate and involvementin decision-making about the new genetics. However, despite the sophistication of scientificknowledge implied in understanding new genetics, it may be too simplistic to resort to a “deficitmodel” of public understanding in which experts consider the public ignorant, and even uninterestedin science.

Drawing upon interviews with women offered prenatal testing, this study explored layunderstanding of ‘genetics’ and genetic testing. Qualitative data analysis revealed that regardless oflevel of technical knowledge, women critically engaged with difficult issues raised by genetic testing,including acceptable uses of testing, the value of testing at the expense of prevention or cure, accessto testing, abortion and quality of life. Moving beyond their personal experiences of testing, womenrecognized the wider social context within which testing was offered, noting the potential for stigmaand discrimination. Results provide support for greater lay involvement in policy discussions anddecision-making about the new genetics.

Methodological Issues in Meta-Analysis of Chronic Diseases: Diabetic Retinopathy in Type 2 DiabetesStephanie Duench

Background:Disease progression studies often report data at vastly different time intervals.Objectives:To quantify and predict the progression of diabetic retinopathy (DR) in type 2 diabetes (T2D).Methods:Systematic review: 38 studies (duration > 12mths) reporting DR incidence data were included(MEDLINE/EMBASE: n=1033 citations, and full-text reviewing: n=158). Two reviewers independentlyconducted data abstraction.Meta-Analytic Model:A 4-state Markov transition model (S0:None, S1:Background, S2:Pre-Proliferative and S4:Proliferative)was used. Observed incidence data was re-expressed as functions of transition rates and durations.Bayesian estimates of incidences and predictions were derived using WinBugs software.Results:The 38 studies included 24,166 participants (males:51%, mean T2D-duration:8yrs, and meanHbA1C:9.1%). Annual transition rates were S0->S1: 0.87(95% credible interval:0.80-0.95); S1->S0:2.18(1.97-2.44); S1->S2: 0.11(0.10-0.12); and S2->S3: 0.21(0.19-0.24). The predicted progression toproliferative DR was 9% (7-11%) and 22%(17-28%) after 10 and 20 years, respectively.Conclusion:Uncertainty propagation, data synthesis and model calibration are facilitated within this meta-analytic approach.


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Narcotic Use in the Five University Health Centers in Québec: A Descriptive Analysis from theProgramme de Gestion Thérapeutique des Médicaments (PGTM)Marie-Claude Michel

Narcotic use in the five University Health Centers in Québec : a descriptive analysis from theProgramme de Gestion Thérapeutique des Médicaments (PGTM) Dr Benoît Bailey CHU Ste-Justine,Jean-François Bussières Pharmacien CHU Ste-Justine, Benoît Cossette Pharmacien CHUS, Dre LouiseDeschênes CHUQ, Céline Dupont Pharmacienne CUSM, Dr Daniel Froment CHUM, Nathalie LetartePharmacienne CHUM, Nathalie Marcotte Pharmacienne CHUQ, Marie-Claude-Michel PharmacienneCHUQ, Dre Danielle Pilon CHUS, Dr Raghu Rajan CUSM, Hélène Roy Pharmacienne CHU Ste-Justine,Martin Turgeon Pharmacien CHUS.

In 2006, hospital centers in Québec had to react upon the publication of a report of a task force andits recommendation concerning the high number of death related to opioid analgesic use. Beforedeveloping new guidelines, the PGTM decided to perform a baseline descriptive analysis on the use ofnarcotics in the five University Health Centers. On June 27th 2006, the centers identified all theiractive narcotic orders and gathered information about the patients and concomitant drug use. ThePGTM pooled the data and the analysis of the results allowed the identification of many potentialtargets for interventions and triggered discussions to improve prescription and safe use of narcotics.Statistics are now available for: favourite narcotic prescribed, route, doses, intervals, use of more thanone narcotic and combinations with central nervous systems depressors. The analysis will be repeatedin June 2007.

Natural History of Chronic HCV Infection Obtained through Injection Drug Use: A Bayesian Meta-AnalysisAva John-Baptiste

Background:Chronic infection with Hepatitis C virus (HCV) can result in cirrhosis of the liver which is associatedwith a large clinical and economic burden. The majority of new infections occur in injection drugusers (IDUs).Objective:To estimate the rate of progression to cirrhosis for those infected with HCV through injection druguse.Methods:A systematic review of the literature identified relevant articles. A meta-analysis of study data wasperformed based on a Poisson regression model, analyzed using Bayesian techniques.Results:The estimated rate of progression to cirrhosis was 5.1 per 1000 person-years with a 95% credibleregion (CR) of 4.5 to 5.6 per 1000 person-years. The study population was the most important factorwith estimates derived from liver clinic studies having a 12-fold higher progression rate compared tocommunity-based studies.Conclusions:Rates of progression for IDUs are comparable to other populations. Prognosis depends on the studypopulation.


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Non-Patented Prescription Drug Price Monitoring and ReportingRon Corvari

As part of the September, 2004 “10-year Plan to Strengthen Health Care”, First Ministers announced aNational Pharmaceuticals Strategy (NPS), one of whose elements is the achievement of internationalprice parity for non-patented drugs. In October 2005, Health Ministers directed PMPRB to monitorand report on these prices. To this end, PMPRB employs drug sales information, acquired from IMSHealth through Health Canada, on eleven countries, and has begun publishing quarterly reports.

The first report (June, 2006) compared Canadian prices of non-patented prescription drugs to thosein other countries, adapting methodologies PMPRB has long used to perform internationalcomparisons of patented drug prices. A second report (October, 2006) examined the structure ofCanadian markets for non-patented drugs, applying several standard measures of marketconcentration. A third report (presently in production) will examine the evolution of markets wherepatents have recently expired, focusing on the extent and timing of generic entry.

A Pilot Survey Examining the Updating Experiences of Health Organizations that Fund and/or ConductSystematic Reviews ResearchChantelle Garritty

Background:To maintain their central role in informing clinical practice and health-care policy, systematic reviewsneed to be kept up to date. However, there is little available guidance about the appropriate timingfor updating a particular evidence-base. Furthermore, updating policies and practices of organizationsare often ambiguous.Objectives:To examine the updating policies and practices of organizations that fund and/or conduct systematicreviews.Methods:A pilot Internet survey on updating policies and practices will target a subset of approximately 20organizations within the systematic reviews community. Surveys will be analyzed descriptively andthematically.Results:Existing updating policies, current strategies in use, and knowledge gaps will be identified.Conclusions:Initial results will inform broader international survey implementation, and organizations aboutpotential ways to increase the general performance and efficiency of their respective updatingpractices.

Preschool Vision ScreeningLesley Dunfield

Preschool vision screening detects vision disorders at an early age, when there is a possibility thatdisorders can be corrected – different professional groups recommending various types of screeningfor children under the age of six years.

The Health Technology Inquiry Service (HTIS) was approached to conduct a report on theeffectiveness of preschool vision screening. This report summarized the published literature and was


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peer-reviewed. Numerous studies were identified that examined effectiveness of preschool visionscreening. In addition, the current practice of preschool vision screening across Canada andrecommendations from various professional organizations was reported.

This report provided information to the requestor regarding the clinical effectiveness and costeffectiveness of preschool vision screening. This information enabled the requestor to make adecision and a provincial vision screening program for kindergarten children aged three to four yearswill begin in 2007/2008.

Prostate Cancer: Predictors of Phase-Specific and Lifetime CostsSteven Carcone

Our objective was to study prostate cancer (PC) costs in Ontario to understand patterns of resourceutilization and provide high-quality longitudinal cost data for economic evaluations. A periodallocation hierarchy was developed to guide allocation of observation time into costing phases (Pre-Diagnostic, Initial, Pre-Final, Final, and Continuing Care). Total direct costs per phase were determinedby linking administrative databases describing hospitalization, physician services, physician visits,drugs, radiation therapy, long-term care, and home care. The net total direct costs/phase/100 patientdays were $303 (Pre-Diagnostic), $1,946 (Initial), $465 (Continuing Care), $206 (Pre-Final), and $1,000(Final). Age had a complex relationship with costs. Costs in the Final phase of life were much higheramong rural residents. Spending was lower among patients with high co-morbidity across mostdisease stages, reflecting lesser (appropriate) treatment intensity. Attributable Canadian lifetimecosts for PC are substantially lower than published estimates based on charges or total costs.Covariates may strongly affect costs.

Providing Evidence on disease Prevention through the Health Technology Inquiry Service Rhonda Boudreau

CADTH provides a Health Technology Inquiry Service (HTIS) to Canadian health care decision makerswho require quick access to health technology assessment information. While full health technologyassessments are the gold standard of evidence, some decisions cannot wait for a full healthtechnology assessment (which takes nine to twelve months) or do not require the depth ofinformation contained within a health technology assessment. HTIS supports these decisions.

HTIS reports are tailored to meet each requestor’s needs. Several HTIS reports address health caredecisions related to disease prevention and examples of these reports illustrate the varying level ofevidence contained in HTIS reports. These reports were used to help make various types of decisions.While report format differed (e.g., the level of evidence included in the report), each report beingtimely and relevant, aided in health-care decision making.

Revascularization and Survival Trends of Canadian Acute Myocardiol Infraction (AMI) patients,1995/96 to 2003/04Helen Johansen

Revascularization can be a key treatment for improving outcomes in heart attack/AMI patients.Trends in revascularization.of AMI patients across nine Canadian provinces were investigated usingStatistics Canada’s linked hospital discharge database (HPOI). Revascularization rates within thirty-


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days of their attack increased in all provinces between 1995/96 to 2003/04. Male rates increased from18% to 44%; female from 12% to 28%. Increases were more pronounced in the Western provinces andQuebec. Although coronary artery bypass graft surgery (CABG) rates increased, the revascularizationincrease was mainly due to percutaneous coronary intervention (PTCA) rates. At the same time, theaverage Charlson Index increased slightly, the length of hospital stay decreased, the time to theprocedure decreased markedly and the percentage who survived thirty days increased. An increase in30-day survival was shown with increasing procedure rates. The variation in cardiac procedures ratesafter AMI may represent potential inequalities in the treatment of AMI.

A Review of Approaches to Considering Ethical, Legal, and Social Issues in Health TechnologyAssessment: Application to Newborn and Prenatal ScreeningBeth K. Potter

It has been argued that ethical, legal, and social issues (“ELSIs”) should be explicitly integrated intoheath technology assessments (HTAs), yet this poses conceptual and methodological challenges (forexample, regarding how ELSIs relate to technologies, the kind of evidence considered, how tointegrate it into HTA, and how to involve stakeholders). As part of a broader knowledge synthesisproject that aims to explore these challenges, we present preliminary findings from a systematicreview. The review examines how ELSIs have been incorporated into published HTAs on newborn andprenatal screening as model technologies. We look both at which ELSIs are covered (for example,psychosocial impacts, the ethics of screening without demonstrated clinical benefits, issues related toinformed consent, broader societal concerns), and the ways in which ELSIs are addressed (for example,literature review, expert consultation, stakeholder participation). We relate these findings to generalHTA methodology and guidelines for conducting HTA.

Review of Risk Issues Associated with Reuse of Single Use Devices (SUDS)Sandra Berzins

The Calgary Health Region (CHR) requested a rapid review of risk issues associated with critical SUDsin order to inform policy decisions. This review was considered in a decision to cease reuse of criticaland semi-critical SUDs in the region, pending evaluation of potential use of 3rd party reprocessors. Adecision-making framework for reuse of SUDs is presented. The focus is on risk, economic andlegal/ethical issues. The evidence regarding SUD reuse safety indicates that for certain devices (e.g.heart catheters) reuse can be safe (in terms of patient infection) and cost-effective as long asstringent reprocessing protocols are followed. However, potential risks associated with reusing SUDsinclude infection, staff and environmental risks, plus legal, ethical, and financial issues that should beconsidered in a reuse policy. Additionally, reuse of SUDs is interwoven with infection control andreprocessing procedure issues in general and as applied to multiple use devices.

A Review of Sources of New Drug Information Used for Horizon ScanningChristine Perras

Objectives:CADTH’s emerging health technologies program scans various sources of drug information forpotential topics. These sources were reviewed to determine which are most useful in terms ofnumber of unique new drugs identified, cost of the source and ease of access.


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Methods:Between November 20 and December 15, 2006, sources of drug information regularly used in ourhorizon scanning program were reviewed by hand. Drugs in phase 3 development were identified andentered unto a spreadsheet with the source, date of publication and indication.Results:A total of 92 new drugs were identified from 21 publications. Of these, 21 drugs were duplicates. Themost common drug cited in the sources was rimonobant (six hits) from six different publications. Thepublication for which the most unique new drug entries were obtained was the FDANews – DrugPipeline Alert, with 25 hits. Thirteen publications had no or few (less than two) hits. Limitations of thisstudy include the use of only one researcher for drug name extraction and the short study duration(four weeks). A table listing the information sources used, their cost and accessibility, and theirranking by number of phase III drugs identified will be included in the poster.Conclusions:Currently, the most useful publication employed by CADTH for horizon scanning to identify newpharmaceuticals is the FDANews – Drug Pipeline Alert. This is a daily electronic newsletter availablefree of charge. Of the 20 other publications scanned, 13 could be considered for omission due to lowyield of unique topics.

The Role of Economic Evidence in Canadian Oncology Reimbursement Decision-Making: To Lambdaand BeyondAngela Rocchi

Objective:To determine the use of economic evidence and the role of cost-effectiveness thresholds in Canadianoncology drug reimbursement decision-making.Methods:A literature search was conducted to identify public information regarding the use of economicevidence and the existence of a threshold (lambda) for economic value. A one-day key informantround table was held with invited individuals from across Canada to glean further information.Results:The limited public information suggests that the uptake of structured economic evidence in thedecision-making process has been tentative, despite its formal requirement. Implicit economicthresholds have emerged elsewhere, but not in Canada. The key informant round table confirmed theinconsistent uptake of economic evidence. Panelists suggested process improvements, including thedevelopment of an explicit Canadian weighting system for evidence and values.Conclusions:Canadian oncology reimbursement decision-makers do not agree about the use of economicevidence, reject cost-effectiveness thresholds, and offer alternate improvements to decision-making.

Are Short-Acting Insulin Analogs Cost Effective: An Economic Review Huimin Li

Background:Short-acting insulin analogs are more expensive than conventional insulin. Given limited health careresources, decision makers need to know if short-acting insulin analogs are justified for all, or onlysome diabetic groups compared with conventional insulin.Objective:To explore the economic benefit of short-acing insulin analogs for diabetes mellitus.


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Method:We searched electronic databases from 1990 onwards, including MEDILINE, BIOSIS Previews, PASCAL,EMBASE and HEED. Two reviewers independently selected the search results according to pre-established criteria.Results:Five economic evaluations satisfied all criteria: two cost comparisons and three willingness-to-paystudies. The two cost comparisons found no significant difference in total health care costs betweencompared insulin interventions. The higher pharmacy cost incurred with insulin analogs was offset bythe lower hospitalization cost. The European WTP study showed that patients would pay an extraC$179 per month for insulin analogs over conventional insulin. The rest two WTP studies, afterincorporating incremental cost of the analogs over conventional insulin, reported annual net benefitvalues: C$352.90 in the Australian study and C$255.36 in the Canadian one.Conclusion:The available economic evidences showed that patients preferred short-acting insulin analogs toconventional insulin and the total direct medical costs were no more with the analogs than theconventional insulin within a 12-month horizon. However, these findings are limited to the specificstudy settings. Future studies should be conducted with a longer time horizon, and be based oncurrent and reliable clinical data.

Stimulant Use in New BrunswickChristine Albino, Brian Carter

It is estimated that 3-5% of children have attention-deficit-hyperactivity-disorder (ADHD) , where theyare unable to control their behaviour or attention. The rapid increase of ADHD prescriptions over timeraises questions about their appropriate use. Using IMS Health databases, we examined prescriptionpatterns of stimulant drugs in New Brunswick (NB) compared to other Canadian provinces. NBshowed just below average 5-year growth rates in stimulant prescriptions of about 25% (Canadianaverage 31.6%). The number of prescriptions per capita by age cohorts shows the 6-12 year agecategory has the highest prescription activity. In Canada, pediatricians prescribe the greatest share ofstimulant prescriptions (about 35%), while in NB, both GPs and Family Medicine prescribe slightlymore than pediatricians. Methylphenidate is the most commonly prescribed stimulant in NB and allother provinces except B.C., AB and MB. This descriptive study is a valuable model for provincial andregional analyses of prescription patterns.

Systematic Review Publication Bias: An International SurveyAndrea Tricco

Background:While researchers have consistently shown that publication bias affects individual studies, this issueis under-explored for systematic reviews (SRs). Increasingly, decision-makers rely on SRs; therefore, SRpublication bias may lead to improperly informed decisions.Objectives:To determine the barriers, facilitators, and factors associated with SR publication bias.Methods:A mixed-mode (e.g., Internet, mail, fax) survey on publication practices was conducted on a randomsample of 625 systematic reviewers.


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Results:53% of participants replied [n=297 (48%) respondents, n=37 (6%) explicitly declined]. Participants feltthat lack of time was a significant barrier, while self-motivation was a significant facilitator, forpublishing a SR. Over 100 unpublished SRs were reported by participants. The reasons that these SRswere not published included manuscript rejection (9%) and too few studies obtained for inclusion (9%).

A Taxonomy of Interventions Directed at Consumers to Promote Evidence-Based Prescribing and DrugUse: A Tool for Evidence-Based Decision-MakingNancy Santesso

Safe and appropriate medication use is a primary goal for health policy makers worldwide. Changingconsumer behaviour is a key component to promoting optimal and appropriate drug use. Considerinterventions directed to consumers such as mass mailings to improve immunisation uptake, orenhanced counselling and the use of patient action plans to improve medication management. Thisbody of research exists but has not been systematically analysed or organised. Without anorganisation of this literature, it can be difficult for policy makers to determine what interventionsexist and which ones are effective. A tool to organise the evidence, such as a taxonomy, can informpolicy makers about which interventions exist and help to identify which interventions work, whichdo not, and where evidence is lacking. Development of the taxonomy, a description of interventionsthat exist and the gaps, and the uses for the taxonomy to inform policy will be addressed.

Time Horizon Bias in Economic EvaluationsBeate Sander

Objectives:To systematically evaluate the impact of time horizon choice on the incremental cost-effectivenessratio (ICER).Methods:A Markov model, comparing two hypothetical strategies, was analyzed for these scenarios:extrapolation of survival benefit (optimistic, intermediate, conservative), prediction of treatment costs(one time costs, continued cost with/without decrease after 10 years), and discount rate(undiscounted, same/differentia discount rate for QALYs and costs).Results:The effect on ICER is greatest when comparing a 5 and 10 year time horizon. The choice of timehorizon conditional on the extrapolation method of survival benefit for one time cost scenarios hadthe greatest impact on the ICER. In scenarios with continued costs, the ICER was sensitive to a costdecrease after 10 years.Conclusions:Most susceptible to bias are scenarios with one time costs as the ICER is most sensitive to the chosenextrapolation method for survival benefits. The choice of time horizon warrants careful consideration.


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The Use of Communication Technologies to Disseminate Research Findings within Drug Policy GroupsMowafa Househ

As the need for knowledge translation grows, so does the need to find new ways for researchers,decision makers and educators to communicate and collaborate with each other on how to improvedrug prescribing and use. Our two-year case study examines the impacts of information andcommunication technologies (ICT) as tools for communication and collaboration between drug policydecision makers, researchers and educators working in a complex set of interactions to improve howdrugs are prescribed and used. More specifically, this case study examines the impacts of ICTs onknowledge translation group processes such as social interactions, information exchange, andknowledge brokering processes within drug policy groups.

In web-conferencing sessions, the knowledge broker reported that more effort was required inpreparing for them, and especially, in the preparation of power point slides. The knowledge broker didnot find this to be an overwhelming task, but rather an incentive to reduce work load because thesame slides could be re-used with other decision making groups.

In our findings, the knowledge broker reported that technology used in face-to-face settings and invirtual environments had a dramatic impact on social interactions

Weighting Clinical Trial Endpoints to Reflect Relative ImportanceAhmed Bayoumi

Clinical trials often use composite or multiple endpoints to evaluate treatment effects, but fewstudies consider the relative importance of individual components. We designed a computer-basedsurvey of heart failure related outcomes reported in the Digoxin Intervention Group Trial. We elicited3068 responses from 301 participants. Heart failure was rated about half as bad as being dead (score49, 95% confidence interval 42 to 55). The scores for dizziness, fatigue, and diarrhea were 60, 77, and76. Each hospitalization was associated with a 5 unit (1 to 9) decrease in the score. Nausea was notassociated with a significant change in score.

The difference between digoxin and placebo was very small when analyzed with these methods.

Conjoint analysis offers a feasible and transparent method of deriving weights for clinical studyendpoints, reflecting their varying importance to patients. This method can be applied to clinical trialsreporting composite or multiple outcomes.

w elcome - cadth€¦ · w elcome 1 welcome welcome to ... bob nakagawa, assistant deputy minister,...

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