Canada's Population Health Model (POHEM): a tool for performing economic evaluations of cancer control interventions

This paper describes the Population Health Model (POHEM) developed by Stati stics Canada and shows its usefulness in the evaluation of cancer control i nterventions and policy decision-making. Models of the costs of diagnosis a nd treatment of lung and breast cancer were developed and incorporated into POHEM. Then, POHEM was used to evaluate the economic impact of chemotherap y 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 treatmen t decision framework was developed to rank order currently available chemot herapy 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. Th is paper demonstrates that POHEM is an effective tool for performing econom ic evaluations of cancer control interventions and to inform healthcare pol icy decisions. (C) 2001 Elsevier Science Ltd.