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Evidence to Improve Care

Conditions of Use of this Site

Use of this site and the information contained in it is prohibited except in accordance with the terms, conditions, and understandings set out below. Do not use this site or the information contained in it if you do not accept the following terms, conditions and understandings :

The information contained on this site is provided as a public service. Although we endeavor to ensure that the information is as current and accurate as possible, errors do occasionally occur. Therefore, we cannot guarantee the accuracy of the information. Readers should, wherever possible, verify the information before acting on it. Without limiting the generality of the foregoing, readers should be aware of the following:

  1. Our interpretation and presentation of technology assessments and other research conducted by other organizations typically condense analysis and conclusions and hence, may omit important information. Readers should check the cited source documents for a full understanding before making any decision based on the information contained here, and should carefully read the purpose, methodology and findings of our assessments relative to the purpose, methodology and findings of other cited assessments of research.
  2. Assessments of new or emerging technologies contain time limited information and should be used with due caution in any case.
  3. This site is intended only to provide information, not advice. Nothing contained on this site is intended as medical or health advice. People seeking individual medical or health advice should consult a physician or appropriate health professional.

As such, the Medical Advisory Secretariat, Province of Ontario and its ministries, agents, boards, commissions, and their advisors, agents, appointees and employees, and the members of the Executive Council of Ontario and their advisors do not assume, and are not responsible for any liability whatsoever for any information contained in, or linked directly or indirectly to, this site, and for any actions or directions taken in reliance on any such information

The Medical Advisory Secretariat uses a standardized costing methodology for all of its economic analysis of technologies. The main cost categories and the associated methodology from the province's perspective are as follows :

  • Hospital : Ontario Case Costing Initiative (OCCI) cost data is used for all program costs when there are ten or more hospital separations or one-third or more of hospital separations in the ministry's data warehouse are for the designated ICD-10 diagnosis and CCI procedure codes. Where appropriate, costs are adjusted for both hospital specific or peer-specific effects. In cases where the technology under review falls outside the hospitals that report to the OCCI, PAC-10 weights converted into monetary units are utilized. Adjustments may need to be made to ensure that the relevant Case Mix Group is reflective of the diagnosis and procedures under consideration. Due to the difficulties of estimating indirect costs in hospitals associated with a particular diagnosis/procedure, the MAS normally defaults to considering direct treatment costs only. Historical costs have been adjusted upward by 3% per annum representing a 5% inflation rate assumption less a 2% implicit expectation of efficiency gains by hospitals.
  • Non-Hospital : These include physician services costs obtained from the Provider Services Branch of the Ontario Ministry of Health and Long Term Care, device costs from the perspective of local health care institutions and pharmaceutical costs from the Ontario Drug Benefit formulary list price.
  • Discounting : For all cost-effective analysis, discount rates of 5% and 3% are used as per the Canadian Coordinating Office for Health Technology Assessment (CCOHTA) and the Washington Panel of Cost-Effectiveness, respectively.
  • Downstream cost savings : All cost avoidance and cost savings are based on assumptions of utilization, care patterns, funding and other factors. These may or may not be realized by the system or individual institutions.

In cases where a deviation from this standard is used, an explanation has been given as to the reasons, the assumptions and the revised approach.

The economic analysis represents an estimate only, based on assumptions and costing methodologies that have been explicitly stated above. These estimates will change if different assumptions and costing methodologies are applied for the purpose of developing implementation plans for the technology.

We do not, by this site, endorse any product, service, process, manufacturer, company, or trademark and any reference to any product, service, process, manufacturer, company, or trademark, does not constitute a recommendation or endorsement by us, and may not be used or attempted to be used as such.

Materials on this site may only be copied or adapted for non-commercial purposes and only after permission is given by the Medical Advisory Secretariat. Please call (416) 314-1092 to request permission.

A copy of this notice must be attached to any hard or soft copy or adaptation made of this material, and the conditions set out above shall apply to any subsequent recipient of the material, copy or adaptation.

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