title: Canada's Population Health Model (POHEM): a tool for performing economic evaluations of cancer control interventions.
abstract: This paper describes the Population Health Model (POHEM) developed by Statistics Canada and shows its usefulness in the evaluation of cancer control interventions and policy decision-making. Models of the costs of diagnosis and treatment of lung and breast cancer were developed and incorporated into POHEM. Then, POHEM was used to evaluate the economic impact of chemotherapy for advanced non-small cell lung cancer; reduced length of hospital stay following breast cancer surgery; and the provision of preventive tamoxifen to women at high risk of breast cancer. A lung cancer chemotherapy treatment decision framework was developed to rank order currently available chemotherapy regimens according to relative cost-effectiveness and cost-utility. Reducing post-surgical breast cancer hospitalisation with optimal home care support could produce major healthcare savings. However, the provision of preventive tamoxifen was estimated to have no population health benefit. This paper demonstrates that POHEM is an effective tool for performing economic evaluations of cancer control interventions and to inform healthcare policy decisions.
authors.affiliation: The Health Analysis and Modeling Group, Statistics Canada, 24-Q, R. H. Coats Building, ON, K1A OT6, Ottawa, Canada.
authors.forename: B P
authors.initials: BP
authors.lastname: Will
authors.forename: J M
authors.initials: JM
authors.lastname: Berthelot
authors.forename: K M
authors.initials: KM
authors.lastname: Nobrega
authors.forename: W
authors.initials: W
authors.lastname: Flanagan
authors.forename: W K
authors.initials: WK
authors.lastname: Evans
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000191:economics* / Q000628:therapy; D002170:Canada; D002289:Carcinoma, Non-Small-Cell Lung / Q000191:economics* / Q000628:therapy; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000191:economics* / Q000628:therapy; D017059:Models, Econometric; D009010:Monte Carlo Method; D019057:Quality-Adjusted Life Years; D013629:Tamoxifen / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D013629:Tamoxifen