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Ongoing Private
Sector Projects

The following projects are currently being completed by DAS.

Client: Sanofi Pasteur

Research Question/Objectives: The objective of this research is to utilize linked health administrative databases in Ontario to establish the burden of Clostridium difficile (CDI) in Canada’s most populous province. Through the use of descriptive statistics, regression modeling and matched case-control analysis, this study will answer important questions about CDI which are necessary for optimal decision-making regarding prevention and treatment planning. Specifically , the research questions of interest are:

  • To measure the annual incidence of CDI in Ontario, both overall and in acute care hospitals, long-term care facilities, and community-dwelling populations 
  • To determine the complication rates associated with CDI in these populations, compared to control groups with similar demographics and medical history 
  • To estimate the cost of health care utilization associated with CDI in Ontario.

Availability of Results: study in progress


Client: Bristol-Myers Squibb

Research Question/Objectives: The objective of this study is to examine the real-world utilization, clinical outcomes and safety profile of non-vitamin K antagonists (novel oral anticoagulants -NOACs) as compared with those of vitamin K antagonists (VKAs) for the prevention of stroke and systemic embolism in patients with atrial fibrillation (AF). The primary objectives of this study will be to evaluate the outcomes in patients with AF receiving NOACs and VKAs, with respect to: stroke and systemic embolism, major bleeding requiring hospitalization, all-cause mortality, and hospitalizations for all causes. The secondary objectives of this study will be to define the characteristics of OAC users as well as to evaluate the treatment patterns of OACs in the management of AF, and their financial impacts, and to furthermore compare outcomes between warfarin and the NOACs –if feasible. Specifically, the research questions of interest are:

  • What are the characteristics within the Ontario Public Drug Plan of the AF population, including those of OAC users and non-users?
  • What are NOAC- and VKA-use patterns among patients diagnosed with AF for the prevention of strokes and systemic embolism?
  • What are the stroke rates overall and in various subpopulations, in patients with AF on each of the NOACs and warfarin and no anticoagulant?
  • In patients with AF, what is the safety profile of NOACs versus VKA in terms of hospitalization for gastrointestinal (GI) bleeding and other major bleeding?
  • What are the relative hospitalization and mortality risks associated with the exposure of each OAC used in the prevention of stroke and systemic embolism?

Availability of Results: study in progress


Client: imshealth | brogan

Research Question/Objectives: Hypoparathyroidism is a rare disease as noted by NORD and typically is caused by damage to the parathyroid during head and neck surgery. Treatment is chronic and consists of vitamin D and calcium supplements. In contrast to hyperparathyroidism, hypoparathyroidism is not well studied, and only five prevalence studies have been published outside of Canada. This study aims to understand the epidemiology and burden of hypoparathyroidism in Ontario. Specifically, the research questions of interest are:

  • What is the prevalence, incidence, and burden of illness of hypoparathyroidism in Ontario?
  • What treatments are received by hypoparathyroidism patients in Ontario?
  • What are the costs and resource utilization of Ontarians with hypoparathyroidism?

Availability of Results: study in progress


Client: Amgen Canada Inc.

Research Question/Objectives: There are minimal data available in Canada describing the prevalence of Atherosclerotic Cardiovascular Disease (ASCVD) as defined in the Canadian Cardiovascular Society dyslipidemia guidelines, nor are there data on the progression of the disease over time and the association with healthcare utilization. With the recent availability of new non-statin medications to lower low density lipoprotein – Cholesterol (LDL-C levels) and demonstrated improvement in morbidity and mortality outcomes in patients treated with these drugs, there is a need to understand the real-world burden of illness and cost of ASCVD to the Canadian healthcare system. Specifically, the research objectives of interest are:

  • To describe the incidence, prevalence, patient characteristics (including comorbidities), and health resource utilization of patients with ASCVD in Ontario, Canada.
  • To describe the time from first ASCVD event to second event, and subsequent event(s), and/or mortality, if applicable.
  • To describe the type of second and/or subsequent event(s) relative to the type of primary event.

Availability of Results: study in progress


Client: imshealth | brogan

Research Question/Objectives: Ulcerative colitis and Crohn’s disease are the most prevalent types of inflammatory bowel diseases (IBD), with etiologies rooted in a complex interplay of genetic, microbial, and environmental factors. The overall objective of this retrospective study is to estimate the health care resource utilization and direct medical costs associated with Crohn’s disease and ulcerative colitis patients, when treated with biologic therapies, and compare the difference by type of index biologic used. Specifically, the research objectives of interest are:

  • Determine the health care resource utilization and direct medical cost of IBD study patient cohort treated with a biologic and retained on it for at least 24 months, compared to a non-IBD cohort.
  • Determine the occurrence of disease specific health outcomes for an IBD study patient cohort treated with a biologic and retained on it for at least 24 months, compared to a non-IBD cohort.
  • Estimate and describe the proportion of patients that are primary non-responders and primary responders.

Availability of Results: study in progress


Client: Hoffmann-La Roche Limited

Research Question/Objectives: Breast cancer is responsible for over one quarter of all new cancer cases among Canadian women. Second to lung cancer, it is the most common cause of cancer death in females and is responsible for almost 137,000 potential life years lost. In the first year after diagnosis average direct health care costs in Ontario are estimated at almost $21,000 (2009 CAD) per patient and lifetime total direct health care costs in Canada are over $300M. Despite the significant clinical and economic burden, recent research studies of the epidemiology, treatment patterns and health care utilization of women with breast cancer in Ontario are limited and do not provide information specific to patient characteristics such as biomarker status (HER2+/-, HR+/-) and TNM staging at diagnosis. The purpose of this study will be to investigate the incidence of breast cancer among women in Ontario and the impact of patient baseline characteristics on patterns of care, clinical outcomes and health care utilization. Specifically, the research objectives of interest are:

  • To determine the epidemiology, treatment patterns and health care resource utilization for women diagnosed with breast cancer.
  • To identify a cohort of incident breast cancer patients and understand their characteristics at diagnosis (e.g. age, disease stage, nodal status, HER2 status, hormone receptor status).
  • To describe patterns of care and clinical outcomes in the cohort.
  • To determine health care resource utilization by disease subtype.

Availability of Results: study in progress


Client: Amgen Canada Inc.

Research Question/Objectives: Osteoporosis and the clinical fractures associated with the disease have significant consequences on human health and quality of life and represent a major burden to society. As with many other chronic and asymptomatic diseases, osteoporosis is under diagnosed and undertreated. The rates of treatment for osteoporosis are also sub-optimal, even among patients who have suffered hip or other fragility fractures. Studies conducted in a variety of different populations indicate that the rates of BMD testing and treatment following fragility fractures are generally <50%, and often <10%. The purpose of this study will be to describe the real-world management (including screening and treatment) and Health Resource Utilization (HRU) of patients subsequent to a primary fragility fracture in Ontario, Canada.

Research Objectives

Primary Objectives:

  • To describe the incidence of primary fragility fractures in patients over (65+).
  • To describe the real-world management, including screening and treatment, and resource utilization following a primary fragility fracture.

Secondary Objectives:

  • To characterize the publicly-insured Ontario fragility fracture patient.
  • To describe patient management, including screening and treatment, prior to a fragility fracture in patients (65+).
  • To describe the rate of subsequent fractures, related procedures, complications, hospitalizations and mortality subsequent to a primary fragility fracture.

Exploratory Objectives:

  • To describe the persistence to osteoporosis treatments in patients (65+) who have had a fragility fracture.
  • To describe comorbidities of interest and steroid-use in patients over (65+) who have had a fragility fracture.
  • To describe opioid pain medications in patients (65+) prior to, and following a fragility fracture.
  • To describe the HRU costs for matched patients who have not had a fragility fracture.
  • To describe mortality for matched patients who have not had a fragility fracture.

Availability of Results: study in progress



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