Why are we organizing another costing supplement in Current Oncology?

Costing Series

Why are we organizing another costing supplement in Current Oncology?

N. Mittmann, MSc PhD*

doi: http://dx.doi.org/10.3747/co.26.4975

Why are we publishing another costing supplement in Current Oncology?

Canadian researchers need an opportunity to describe real-world health system use and costs in their jurisdictions. Reviewers at international journals do not have an appreciation of our unique population size and demographics, and the differences in policies and programs across our country. As an example, a question from the reviewers at a major U.S. cancer journal that we recently fielded asked “Is [Ontario] a major metropolitan area?” Important work conducted from a Canadian perspective might not resonate with non-Canadian audiences. Authors are sometimes hesitant to name a Canadian jurisdiction overtly in an abstract or title for fear that the editor of a non-Canadian journal will not understand the significance of the work.

As cancer-drug costs continue to rise, there is—now more than ever before—a need to understand the Canadian context with respect to costs and health system resource use. Newer targeted agents, immuno-oncology products, and the promise of chimeric antigen receptor T-cell therapies create a greater need to understand how care is managed and used in the real world and to conduct relevant economic analyses. Importantly (to simplify matters), costing occurs in 3 phases:

  • ■ Identify the resource used (without identification, costing is impossible)

  • ■ Quantify the resource (how much is being used?)

  • ■ Apply a value to the resource (unit cost of the resource)

Those three steps allow researchers to determine the burden of disease, the management of the disease, the cost of procedures, and (used as numerator) the inputs into formal economic evaluations.

The supplement you are reading includes seven publications, of which five studies from four provinces use provincial databases. Administrative databases across the country collect and report data about demographics, diseases, outcomes, and health care encounters. Those population-level databases allow the researcher to understand management across the care continuum. From Ontario, Seung et al.1 provide data relating to the real-world management of non-small-cell lung cancer, while Monakova and colleagues2 use micro-costing and administrative data to establish funding rates for endoscopic procedures. Sam and Cheung3 use Alberta Health Services administrative databases to compare the costs of cancer and non-cancer diagnoses, finding that, overall, cancer costs are higher than the costs for other diseases. Tran and colleagues4 use the Saskatchewan Cancer Agency’s cancer registry to identify cases of non-melanoma skin cancer, examining total and annual health system costs. Finally, Costa et al.5 conducted a costing analysis of diffuse large B-cell lymphoma from a British Columbia provincial perspective.

Other studies included in this supplement use Canadian costs for incremental analyses and risk-based assessments. Cheung et al.6 consider the economic impact of the transition from branded to generic oncology drugs and the incidence-adjusted health care costs for common cancer and non-cancer diagnoses respectively, and Blair and colleagues7 link census-derived location data and Statistics Canada’s Canadian Community Health Survey to highlight the importance of socioeconomic status and income with respect to the uptake of colorectal screening.

As the need for health services, economic methods, and outcomes increases, Current Oncology should be applauded for providing a space for publications that allow authors to use administrative data and costing analyses in unique ways, providing useful insights into various Canadian jurisdictions and representative Canadian applications.

This supplement was supported in part by funding from the Ontario Institute for Cancer Research. We thank the Institute for its ongoing support of health services and economic research in cancer. We also thank the Canadian Centre for Applied Research in Cancer Control for their support and ongoing commitment to understanding and improving health policy, health services, and health economics research. Finally, we thank the scientists, researchers, and clinicians who are asking interesting health services and health economics questions relevant to our country.


The Ontario Institute for Cancer Research (oicr) is funded by the Government of Ontario through the Ministry of Economic Development, Job Creation and Trade. The Canadian Centre for Applied Research in Cancer Control (arcc) receives core funding from the Canadian Cancer Society (grant no. 2015-703549). Both oicr and arcc are proud to support the publication of this costing series.


I have read and understood Current Oncology’s policy on disclosing conflicts of interest, and I declare that I have none.


*Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON.


1 Seung SJ, Hurry M, Hassan S, Walton RN, Evans WK. Cost-of-illness study for non-small-cell lung cancer using real-world data. Curr Oncol 2019;26:102–7.

2 Monakova J, Wong J, Blais I, et al. Establishing funding rates for colonoscopy and gastroscopy procedures in Ontario. Curr Oncol 2019;26:98–101.

3 Sam D, Cheung WY. A population-level comparison of cancer-related and non-cancer-related health care costs using publicly available provincial administrative data. Curr Oncol 2019;26:94–7.

4 Tran DA, Coronado AC, Sarker S, Alvi R. Estimating the health care costs of non-melanoma skin cancer in Saskatchewan using physician billing data. Curr Oncol 2019;26:114–8.

5 Costa S, Scott DW, Steidl C, Peacock SJ, Regier DA. Real-world costing analysis for diffuse large B-cell lymphoma in British Columbia. Curr Oncol 2019;26:108–13.

6 Cheung WY, Kornelsen EA, Mittmann N, et al. The economic impact of the transition from branded to generic oncology drugs. Curr Oncol 2019;26:89–93.

7 Blair A, Gauvin L, Ouédraogo S, Datta GD. Area-level income disparities in colorectal screening in Canada: evidence to inform future surveillance. Curr Oncol 2019;26:e128–37.

Correspondence to: Nicole Mittmann, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5. E-mail: nicole.mittmann@sunnybrook.ca

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Current Oncology, VOLUME 26, NUMBER 2, April 2019

Copyright © 2019 Multimed Inc.
ISSN: 1198-0052 (Print) ISSN: 1718-7729 (Online)