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CANADIAN COORDINATINGOFFICE FOR HEALTH

TECHNOLOGY ASSESSMENT

OFFICE CANADIEN DE

COORDINATION DE L’ÉVALUATIONDES TECHNOLOGIES DE LA SANTÉ

COMPUS: A NEW DIRECTION FOR CCOHTACCOHTA will deliver a new program to promote best practices in drug prescribing and use.

Funded by Health Canada, the Canadian OptimalMedication Prescribing and Utilization Service(COMPUS) aims to gather and evaluate best practiceinformation and to develop tools to promote the use of best practices by health care professionals and consumers.

Best practice activities strive to improve drug-relatedhealth outcomes and the cost-effective use of medica-tions by changing knowledge, attitudes and, ultimately,behaviour.

"COMPUS will provide Canadians with a centre ofexpertise in best practices," said CCOHTA Presidentand CEO Dr. Jill M. Sanders. "Our health technologyassessment and common drug review programs guidethe introduction of drugs and health technologies intothe Canadian health care system. COMPUS will helpguide the appropriate use of drugs once in the system,making COMPUS a logical addition to CCOHTA'srange of programs."

COMPUS will initially focus on three drug classesand diseases that have been identified as areas whereimprovements to medication prescribing and usewould have significant impact: anti-hypertensives

(drugs used to lower blood pressure), proton pumpinhibitors (drugs for the treatment of gastrointestinalproblems), and diabetes management.

COMPUS will undertake a variety of activities,including:

Collecting, evaluating and distributing best practice information, strategies and tools

Facilitating best practices among health careproviders and patients/consumers by supportingand encouraging best practice initiatives

Linking and coordinating with domestic and international best practice initiatives

A detailed work plan for COMPUS is scheduled to be completed in June. As details of the program arefinalized, they will be posted on CCOHTA's web site(www.ccohta.ca)

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C O N T E N T S

"COMPUS will help guide the appropriate use of drugs once

in the system." Dr. Jill M. Sanders

CCOHTA President and CEO

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BUILDING HTA CAPACITY ACROSS CANADA

CANADIAN HTA CONFERENCE

CCOHTA is building the capacity to produce and useHTA throughout Canada through two new initiatives.

Grants Program CCOHTA'S HTA Capacity Building Grants programsupports projects that will improve or refine HTAmethodologies, improve knowledge transfers processes,increase training opportunities and support graduatestudies in HTA.

In March, CCOHTA awarded grants totaling $1.6million to support 21 projects, ranging from newways to package HTA information for decision makersto approaches for public involvement in priority-setting for HTA, to adapting cost-effectiveness information from other countries to support informeddecisions in the Canadian context.

Summaries of approved projects are available onCCOHTA's web site at www.ccohta.ca.

The grants program will continue in 2005, but the focuswill shift from supporting existing HTA capacity tobuilding new capacity. Program details will be announcedlater in the year. CCOHTA anticipates funding 15-20projects with a total value approaching $1.3 million.

Increased contractingOver and above its grants program, CCOHTA willspend more than $2 million this year to support HTAwork by qualified organizations across Canada. Notonly will contracting assessment work build HTAcapacity across Canada, it will also increase the numberof assessments available to support decision-making.CCOHTA expects an 8-10 additional projects will becompleted this year through this initiative.

CCOHTA will host a Canadian HTA conferenceearly in 2005 to support HTA capacity building inCanada and increase the visibility of HTA in thehealth care system.

The conference will focus on the new CanadianHealth Technology Strategy, which is scheduled forapproval by Canada's First Ministers in September2004. The conference will also provide a forum forinteraction and networking between Canadian HTAresearchers, policy-makers and academics.

The date and location of the conference will be set shortly.If you would like to be on the conference mailinglist, please send an email to conference@ccohta.ca.

If you are interested in helping with conferenceplanning and delivery, please contact Peter Chinneck, Director, Communications, CCOHTA at (613) 226-2553 x222, or by e-mail at peterc@ccohta.ca

ConnectionPublished by: Canadian Coordinating Office for Health

Technology Assessment (CCOHTA)Available on CCOHTA’s web site: www.ccohta.caEditor: Kerrie Whitehurst Layout: Martha HodgsonTo request publications: 600-865 Carling Avenue,

Ottawa ON Canada, K1S 5S8Tel. (613) 226-2553 Email: pubs@ccohta.ca

ISSN 1481-2088 (print) ISSN 1481-2096 (online)PUBLICATIONS AGREEMENT NO. 40026386

RETURN UNDELIVERABLE CANADIAN ADDRESSES TOCANADIAN COORDINATING OFFICE FOR HEALTH

TECHNOLOGY ASSESSMENT, 600-865 CARLING AVENUE, OTTAWA ON K1S 5S8

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♦ Explicit considerations of equity inhealth technology assessment

St. Michael’s Hospital, Toronto

♦♦ Indirect evidence: indirect treatment comparisons in meta-analysis

University of Ottawa

♦♦ Public involvement in priority-setting for HTA: a citizen’s jury approach

University of Alberta

♦♦ User-friendly surgical HTA databaseCalgary Health Region

♦♦ A decision-making framework for prioritizing health technology assessments

McMaster University

♦♦ Project “Know4Go’: Packaging HTAknowledge to improve decision making

London Health Sciences Centre

♦♦ A proposal to increase HTA knowledgetransfer activities in Alberta

Calgary Health Region

♦♦ HTA capacity building through education,training and distance learning

Canadian Cochrane Network and Centre

♦♦ MLIS co-operative work-study placementsin HTA and systematic evaluation review (SER)

University of Western Ontario.

♦♦ Training information professionals to support HTA, evidence-based decision-making and knowledge transfer

University of Western Ontario

♦♦ Graduate student support for doctoralcandidates in health technology assessment

University of Alberta

Did You Know?The "outreach" section of CCOHTA's web site contains

a link to events of interest to the HTA community. Visitors to our site can also:

♦ View a list of CCOHTA-sponsored events♦ Find out where CCOHTA staff members have been making presentations

♦ Download presentations made by CCOHTA staff

www.ccohta.ca

Some of the projects currently funded through CCOHTA's HTA capacity building grants program

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5th European Conference on HealthEconomicsSeptember 8-11, 2004, London, UKThe conference will include presentations on allaspects of health economics, including financing andresource allocation, economic evaluation, econometricsin health economics, incentives in health care, equityin health and health care, outcomes evaluation, phar-maceutical economics, social care and mental healtheconomics. The conference will include a memorialsession in honour of Dr Bernie O'Brien.

For more information, please visit: www.healtheconomics.org

12 Annual Cochrane CollaborationColloquiumOctober 2-6, Ottawa, ON, Canada

As indicated by the theme of "Bridging the Gaps", thefocus of the 12th Cochrane Colloquium is to bridgesome of the key gaps that have been identified: gapsbetween The Cochrane Collaboration and clinicalpractice, gaps between high and low-income countriesand individuals, gaps between methodologists andreviewers, and gaps between producers and users ofhealthcare information. A special session on Cochraneand HTA will be held on Tuesday, October 5.

See related story on page 5.For more information, please visitwww.colloquium.info

26th Annual Meeting of theSociety for Medical Decision MakingOctober 17-20, 2004, Atlanta, GA, USAThe three-day annual meeting is preceded by a day ofoptional Short Courses. Presentations and critiques oforiginal research are complemented by special sym-posia, panel discussions, and a keynote address by aleader in the field. Interest group meetings allow mem-bers to share interests and concerns in specific areas.

For more information, please visit www.smdm.org

21st International Conference of TheInternational Society for Quality inHealth Care (ISQua)October 19-22, 2004, Amsterdam, The Netherlands

ISQua's international conferences provide a stimulat-ing forum for exchanging information and updates onpractice and policy development. Delegates includenational health policy leaders and decision-makers,researchers, healthcare professionals in all disciplines,representatives from clinical organisations, standardsand accreditation organisations, healthcare networks,providers and consumer organisations.

For more information, please visit www.isqua.org.au

CONFERENCE SCANA round-up of upcoming conferences of interest to producers and users ofevidence-based information about health technologies

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COCHRANE COMESTO OTTAWA

International Society forPharmacoeconomics and OutcomeResearch (ISPOR) 7th AnnualEuropean ConferenceOctober 24-26, 2004, Hamburg, GermanyISPOR is an international organization promoting thescience of pharmacoeconomics and health outcomesresearch. Its annual conference provides a forum tofacilitate the interchange of scientific knowledge inpharmacoeconomics and patient health outcomes andencourage communications among the research com-munity, health care professionals, and other research,regulatory, and educational groups.

For more information, please visit www.ispor.org

Did You Know?

All CCOHTA reports and Emerging Technology Bulletins

are available on-line.

Subscribe to our email notificationservice to hear the news first!

(www.ccohta.ca)

The international CochraneColloquium will be held inOttawa from October 2 - 6, 2004.

The Cochrane Collaboration is an international, not-for-profitorganization. Its mission is tohelp people make well-informeddecisions about health care by preparing, maintainingand promoting the accessibility of systematic reviewsof healthcare interventions.

An annual event, the Cochrane Colloquium bringstogether international experts for four days of discus-sions, workshops, plenary sessions and meetings.

The theme of this year's Colloquium in Ottawa isBridging the Gaps. Discussions will focus on gapsbetween methodologists and reviewers, between producers and users of healthcare information,between high and low-income countries and individuals, and between The Cochrane Collaborationand clinical practice.

The scientific program of workshops, papers andposters will help to stimulate discussion and solu-tions. As well, over 80 Collaboration groups will bemeeting during the Colloquium. These meetings willprovide an ideal opportunity for participants to learnmore about the Cochrane Collaboration and toengage actively in determining its future.

Participation in the Colloquium is open to anyonewho is interested in the work of the Cochrane groups,whether a founding member, a newcomer, or some-one curious about the work of the CochraneCollaboration. Registration details, along with infor-mation on sessions and workshops, are available at www.colloquium.info

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CCOHTA REPORTS PUBLISHED DURING2003-2004

Name of report Date Brief description

Riluzole for the treatment of amyotro-phic lateral sclerosis: an assessment of clinical efficacy and safety

Aug. 2003 Assesses the potential benefits and harms ofusing riluzole to treat patients with ALS

Drugs to prevent gastro-duodenalulcers associated with the use ofNSAIDs

Sept. 2003 Compares the efficacy and safety of gastro-protective agents when used to protectagainst NSAID-induced (traditional, COX-2selective) GI damage.

Auto-titrating nasal continuous positiveairway pressure systems in the manage-ment of obstructive sleep apnea

Sept. 2003 Systematically reviews efficacy, effectivenessand costs of APAP devices used to diagnoseand treat obstructive sleep apnea syndrome

HPV testing and liquid-based tech-niques for cervical cancer screening

Nov. 2003 Evaluates the diagnostic accuracy of LBC andHPV testing to detect cervical lesions, compared to Pap smear; assesses cost-effectiveness

Molecular diagnosis for hereditary cancer predisposing syndromes

Nov. 2003 Analyzes genetic tests that screen and diag-nose hereditary cancer predisposing syn-dromes; documents the impact of genetictests on clinical management of patients

Spinal manipulation for infantile colic Nov. 2003 Assesses safety of spinal manipulation;reviews whether it can reduce the signs andsymptoms of colic in infants

Telephone triage services Nov. 2003 Evaluates teletriage cost-effectiveness andeffects on health service use, caller safety,satisfaction, quality of life

Bisphosphonate drugs to manage painsecondary to bone metastases

Jan. 2004 Compares effectiveness and safety of usingbisphosphonate drugs, compared to alterna-tives, to manage pain for patients with bonemetastases

Technology Reports

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Technology Overviews

Comparative clinical and budgetevaluations ofrosiglitazone andpioglitazone withother anti-diabeticagents

April 2003

A clinical and economic review of strokerehabilitation services August 2003

A clinical and economic review of exercise-based cardiac rehabilitation programs forcoronary artery disease August 2003

Gastroduodenal ulcers associated with theuse of non-steroidal anti-inflammatory drugs

March 2004

Emerging HealthTechnology Bulletins

Alefacept: potential new anti-psoriatictherapy for patients with moderate-to-severedisease

April 2003

Atomoxetine for attention deficit/hyperactivitydisorder May 2003

Transcatheter closure of atrial septal defects May 2003

Multi-slice/helical computed tomography forlung cancer screening June 2003

Ezetimibte for lowering blood cholesterol September 2003

Enfuvirtide, a new treatment for HIV infection October 2003

Treatment of osteoporosis with teriparatide:many unknowns? November 2003

Insulin glargine: a long-acting insulin for diabetes mellitus November 2003

Wireless capsule endoscopyDecember 2003

Endoscope-based treatments for gastro-esophageal reflux disease March 2004

Did You Know?CCOHTA produces a variety of HTA publicationsto meet the needs of health care professionals:

♦ Technology reports: full assessments; detailed technical

reports that are peer reviewed♦ Technology overviews:

summaries of technology reports♦ Emerging health technology bulletins:

highlight developing technologies that are not yet in widespread use in Canada

♦ Emerging drug list:early assessments based on horizon scanning

♦ Emerging technology list:early assessments based on horizon scanning

♦ Pre-assessments: a quick guide to current assessment information on a topic

A complete list is available at www.ccohta.ca

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CDR - the Common Drug Review - is a programdelivered by CCOHTA on behalf of participating federal, provincial and territorial drug benefit plans in Canada. CDR is a single process for reviewing newchemical entities and new combination products andproviding listing recommendations to participatingdrug plans. It provides a systematic review of theavailable clinical evidence, a review of the pharma-coeconomic data and a formulary listing recommen-dation by an expert advisory committee.

CEDAC reviews first fivedrug submissionsThe Canadian Expert Drug Advisory Committee(CEDAC) met on April 28, 2004 to review the firstfive drugs submitted to the CDR: Axert, Combigan,Evra, Iressa and Reyataz.

As part of the CDR process, CEDAC makes a listingrecommendation. The participating drug plans consid-er this recommendation and the mandates, prioritiesand resources of their respective plans when decidingwhether to list the drugs on their formularies.

Participating drug plans have provided strong supportfor the CDR program and are committed to reviewingCEDAC recommendations in a timely manner.

To date CDR has received eight submissions in additionto those reviewed by CEDAC on April 28, and they arecurrently at different stages in the CDR review process.As these submissions go through the process, theirprogress can be tracked through detailed status reports,which can be found in the CDR section of the CCOHTAweb site. A schedule of CEDAC meetings is also posted.

CDRC info now on-lineThe Common Drug Review Committee consists ofrepresentatives from each of the participating feder-al/provincial/territorial drug plans, the Director ofCDR, and selected observers. The CDRC acts as aliaison between the participating plans and the CDRDirectorate by providing a forum for identifying anddiscussing common drug-related issues and communi-cating them, as required, to the CDR Directorate andCEDAC for action or information. CDRC membersheld a meeting at CCOHTA on April 1 and meet regu-larly via teleconference.

Detailed information on the CDRC is now availableon the CCOHTA web site. Included are the terms ofreference, a list of members and links to each of theparticipating drug plans.

CDR UPDATE

Information on the Common Drug

Review Committee (CDRC)is now available

at www.ccohta.ca.

CEDAC MEMBERS AT THE APRIL 28TH MEETING INOTTAWA (LEFT TO RIGHT): DR. DALE QUEST, CEDACCHAIR DR. ANDREAS LAUPACIS, DR. MARGOT J.BURNELL, DR. BRUCE CARLETON AND DR. MICHAEL EVANS.

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Stakeholder/outreach activities The CDR Directorate'sactivities have includedongoing liaison withstakeholders from indus-try and patient and con-sumer groups.

Transparency and open communication with stake-holders continue to be priorities. The Directorate reg-ularly delivers presentations, participates in meetings,and responds to stakeholders' inquiries and concerns.

Human resources developments at CDRThe continued growth of the CDR Directorate and theaddition of COMPUS (see story, page 1) has resultedin some changes to staffing at CCOHTA.

Barb Shea has been appointed Vice President of CDRand COMPUS and will assume overall responsibilityfor the two programs.

Elaine MacPhail has been appointed Director, CDR.

Recent additions to CDR staff include Karen Lee,health economist, Pinggang Liu, clinical reviewer andSandy Fox, communications officer.

Now that the permanent CDR is fully operational, moreteam members and clinical reviewers are needed. For acomplete list of available positions, visit the "Careers"section of CCOHTA's web site at www.ccohta.ca

Contact CDRMedia and general requests for information on CDRcan be directed to Sandy Fox at (613) 226-2553 x233,sandyf@ccohta.ca.

For questions on the submission process and individualsubmissions, contact Elaine MacPhail at (613) 226-2553 x230, elainem@ccohta.ca.

To receive CDR updates electronically, send an e-mail to cdr@ccohta.ca, with "Subscribe to CDRUpdate" in the subject line.

Did You Know?

CEDAC Recommendations and Reasons for Recommendations are be posted

on CCOHTA’s web site when finalized.

Check the CDR page at www.ccohta.ca

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A NEW VP OF HTA FOR CCOHTA CCOHTA is pleased to announce that Mike Gaucherhas been appointed as the new Vice President of theHealth Technology Assessment directorate.

As Vice President, Mr. Gaucher has overall responsibility for managing CCOHTA's HTA direc-torate and its programs and staff. He will also serveas a member of CCOHTA's executive managementgroup.

Mr. Gaucher has been serving as interim VP, HTAsince January 2004.

CCOHTA President and CEO, Dr. Jill Sanders, saysthat Mr. Gaucher's 20 years' experience as a manager,practitioner and researcher is extremely valuable tothe organization. "Mike's knowledge and expertisewill serve CCOHTA well as we continue to build onexisting relationships within the HTA community andevolve to meet the needs of Canadian health caredecision makers," said Dr. Sanders. "He will play apivotal role as CCOHTA grows and fulfills its role inthe management of health technology as required bythe Canadian Health Technology Strategy."

Mr. Gaucher holds anundergraduate degree in Pharmacy and aMasters in BusinessAdministration. He has 15 years' experience inhospital pharmacy man-agement where he wasinvolved in strategic plan-ning, policy and programdevelopment, research,and drug use/formularymanagement. Mr. Gaucherhas worked extensively with hospital and provincialdrug committees, including the Advisory Committee onInstitutional Pharmacy Practice and the FormularyCommittee of Saskatchewan Health.

Mr. Gaucher held a cross-appointment as a ClinicalAssistant Professor for ten years at the College ofPharmacy and Nutrition, University of Saskatchewan.He has been actively involved in several professionalassociations and has held executive appointments withprovincial and national pharmacy organizations.

MIKE GAUCHER

Did You Know?We are hiring!

To obtain details on these and other positions, please visit our web site at www.ccohta.ca and look under “Careers.”

Interested candidates should submit their curriculum vitae via e-mail to hr@ccohta.ca

♦ Health Economists ♦ Liaison Officers

♦ Analyst, CDR ♦ Knowledge Transfer Officer

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CANADIAN CONNECTIONS

Institute for ClinicalEvaluative Sciences (ICES) www.ices.on.ca

New ReleasesICES Research Atlas: Use ofLarge Bowel Procedures inOntario (March 2004)

"At a Glance" monthly e-bul-letin - provides summaries ofrecent ICES research findingsfor stakeholders

Alberta HeritageFoundation for MedicalResearch (AHFMR) www.ahfmr.ab.ca

New ReleasesOvulation induction drug therapyfor anovulatory infertility associated with polycysticovary syndrome (March 2004,full assessment)

Use of cannabis or cannabinoidsfor non-malignant chronic pain(February 2004, TechNote)

Botulinum toxin type A injectionfor achalasia and anal fissure(February 2004, TechNote)

Botulinum toxin type A injectioninto the iliopsoas muscle(February 2004, TechNote)

Adult to adult living donor livertransplantation (February 2004,TechNote)

Decision making for health caresystems: a legal perspective(October 2003, HTA Initiative)

Review of health technologyassessment skills developmentprogram (December 2003,HTA Initiative)

Agence d'évaluation destechnologies et des modesd'intervention en santé(AETMIS) www.aetmis.gouv.qc.ca

New ReleasesEndometrial ablation techniquesin the treatment of dysfunctionaluterine bleeding (February 2004)

Low-intensity ultrasound(ExogenTM) for the treatment offractures (March 2004)

Postural support devices(March 2004)

Efficacy of external counter-pulsation in the treatment ofchronic angina (March 2004)

Evaluation of photodynamictherapy with porfirmer sodiumfor esophageal, bladder andlung cancer (late May 2004)

Manitoba Centre forHealth Policy www.umanitoba.ca/centres/mchp

New ReleasesPatterns of health care use andcost at the end of life(February 2004)

Using administrative data todevelop indicators of quality infamily practice (March 2004)

Diagnostic imaging data inManitoba: assessment andapplications (late May 2004)

Coming SoonPatterns of regional mentalhealth disorder diagnoses andservice use in Manitoba: apopulation-based study (June 2004)

Referenced-based pricing vs.utilization management (July 2004)

A QUICK REVIEW OF WHAT'S NEW IN HEALTH RESEARCH ACROSS CANADA

WITH AN HTA FOCUS

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Health Quality Council www.hqc.sk.ca

New ReleasesUpdate newsletter (March 2004)

Improving management ofchronic diseases (March 2004)

Improving drug management inlong-term care (March 2004)

Improving skin and wound carein Saskatchewan (March 2004)

Improving primary health carein Saskatchewan (March 2004)

Coming SoonReport on quality of care foracute myocardial infarctionpatients in Saskatchewan (June 2004)

Centre for Health Servicesand Policy Research(CHSPR)www.chspr.ubc.ca

New ReleasesBritish Columbia Health Atlas,2nd edition (April 2004)

Primary health care mappingproject (late May 2004)

New ReleasesEmerging technology bulletins:

Endoscope-based treatments for gastroesophagealreflux disease

Gefitinib for advanced or metastatic non-small celllung cancer

Technology reports:Impact of radiation wait times on risk of localrecurrence of breast cancer: early stage cancerwith no chemotherapy

Inteferon-based therapies for chronic hepatitis Cvirus infection: an assessment of clinical outcomes

ComingSoonEmerging technology bulletins:

IndependenceTM iBOTTM 3000 Mobility System: a stair climbing wheelchair

Omalizumab as add-on therapy to inhaled steroidsfor asthma

Ximelagatran for the prevention and treatment ofvenous thromboembolism

Technology report:Economic evaluation of glycoprotein IIb/IIIainhibitors in patients with acute coronary syndrome undergoing percutaneous coronaryinterventions with stenting

CANADIAN CONNECTIONS

CCOHTA PUBLICATIONS