250 Estimating the Canadian costs of poisonings and the cost effectiveness of poison centres

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Background Poisoning is a significant public health issue in Canada and the third leading cause of injury-related death. The number of unintentional poisoning deaths and hospitalizations has been increasing since 2008 and, since 2015, poisoning now results in more fatalities per year than transport. Objective To examine the health and economic costs of poisoning to support public health policies aimed at minimising losses to society, and to calculate the cost savings of poison centres in Canada. Methods Societal and health system costs were calculated using 2018 to 2020 annual average data and expressed in 2020 dollar values. The Electronic Resource Allocation Tool (ERAT), a spreadsheet-based injury classification and costing model was used to calculate costs. The costing method was based on a societal, or population, perspective, using an incidence and human costing approach. Direct costs of poisoning deaths, hospitalizations, emergency department visits, disabilities, ambulance attended calls, and calls to poison centres were calculated. These costs included the lifetime medical costs and indirect costs or lifetime productivity losses due to poisonings. Value of Statistical Life (VSL) was calculated to obtain the cost that individuals would be willing to pay to make investments in the prevention of poisonings. The potential reduction in health-care resource utilization for unintentional, low-risk poisonings due to the availability of poison centre services was estimated. Results There was an average of 5,792 deaths, 29,187 hospitalizations, 103,792 emergency department (ED) visits, and 136,793 calls to poison centres from poisonings in Canada between 2018 and 2020, with males having the highest rates for deaths and ED visits at 21.8 and 298.8 per 100,000 population, respectively. Majority of these cases were from unintentional drug poisonings. The average direct costs of poisonings was $1.5 billion and the average indirect costs of poisonings was $4.4 billion. The VSL for deaths was $45.8 billion. Conclusions The involvement of poison centres in the care pathway is a unique feature of poisonings and is important to include in the measurement and communication of the cost of poisoning. The costing results will assist decision and policy makers in developing a business case for poison prevention.

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