Evidence map›Paper›PMID 24726076›Full record

ArticleHealthcare policy = Politiques de sante2014

Provincial disparities of growth hormone coverage for young adult survivors of paediatric brain tumours across Canada.

Haroon Hasan, Fuchsia Howard, Steven G Morgan, Daniel L Metzger, Andrea C Lo, Karen Goddard, Sabrina Gill, Michelle Johnson

Open access · bronzeAbstract read
PubMed Full text at PMC
In one paragraph

Article in Healthcare policy = Politiques de sante, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 89% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Haroon HasanProject Manager, Department of Radiation Oncology, BC Cancer Agency, Vancouver, BC.
Fuchsia HowardPost-Doctoral Fellow, School of Population & Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC.
Steven G MorganProfessor & Associate Director, Centre of Health Services and Policy Research, University of British Columbia, Vancouver, BC.
Daniel L MetzgerPaediatric Endocrinologist & Clinical Professor, University of British Columbia, Clinical Investigator, Child Family Research Institute, Endocrinology & Diabetes Unit, BC Children's Hospital, Vancouver, BC.
Andrea C LoRadiation Oncology Resident, Department of Radiation Oncology, BC Cancer Agency, Vancouver, BC.
Karen GoddardRadiation Oncologist, Department of Radiation Oncology, BC Cancer Agency, Clinical Associate Professor, University of British Columbia, Vancouver, BC.
Sabrina GillAdult Endocrinologist, Division of Endocrinology, St. Paul's Hospital and Clinical Associate Professor, University of British Columbia, Vancouver, BC.
Michelle JohnsonAdult Endocrinologist, Division of Endocrinology, St. Paul's Hospital and Clinical Assistant Professor, University of British Columbia, Vancouver, BC.
BC Cancer Agency · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundYoung adult survivors of paediatric brain tumours (PBTs) who have been treated with radiation therapy will likely be severely growth hormone-deficient when retested at the achievement of final height. Growth hormone replacement therapy (GHRT) is administered to treat growth hormone deficiency (GHD). Public drug coverage for GHRT falls under the responsibility of provincial governments across Canada. This study sought to determine the extent of public drug coverage and cost in each Canadian province for GHRT to treat GHD during adulthood for young adult survivors of PBTs.

methodsData were collected from provincial government resources and drug formularies from 2012-2013 on the extent of coverage for GHRT based on a clinical case scenario representative of a young adult survivor of a PBT with childhood-onset radiation-induced GHD, the ingredient cost for GHRT and the applicable provincial public drug plan cost-sharing policies. A model was then created to simulate out-of-pocket costs incurred by a young adult male and a young adult female survivor of a PBT for one year of GHRT in each province with applicable cost-sharing arrangements and levels of low annual individual total income that best represent the majority of young adult survivors of PBTs. Out-of-pocket costs were expressed as a percentage of annual income. Comparisons were made between provinces descriptively, and variation among provinces was summarized statistically.

resultsAlberta, Manitoba, Ontario, Quebec, New Brunswick, and Newfoundland and Labrador provide coverage for GHD during adulthood on a case-by-case basis, while British Columbia, Saskatchewan, Nova Scotia and Prince Edward Island provide no coverage. The percentage of annual income to fund GHRT across the provinces without public coverage ranged from 14.4% to 25.5% for males and 21.5% to 38.3% for females, and with public coverage was 0.0% to 4.1% for males and 0.0% to 5.0% for females.

interpretationThere are considerable out-of-pocket costs and variation in coverage provided by provincial public drug plans to fund GHRT for young adult survivors of PBTs with GHD. The implementation of a national drug formulary could potentially prevent undue financial hardship and remove disparities resulting from variations in provincial drug plans.

Indexed as

Brain NeoplasmsHealthcare DisparitiesInsurance CoverageSurvivorsAdolescentAdultCanadaChildChild, PreschoolDatabases, FactualFemaleFinancing, PersonalHuman Growth HormoneHumansInfantMaleHuman Growth Hormone

Identifiers

PMID24726076
PMCPMC3999568
OpenAlexW2066182106

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.