Navigating Choices in Nephrology: The Role of Patient-Reported Outcomes and Preferences in Economic Evaluations and Decisions in Health Care

Abstract

The increasing burden of chronic kidney disease (CKD) on the healthcare system highlights the need to prioritize services and manage the use of resources efficiently. Amidst these financial constraints, key decision-makers must weigh the impact of an intervention or program on healthcare expenditure when determining the allocation of limited resources. Patient-Reported Outcome Measures (PROMs) are relevant in health economic decision-making within nephrology. Health-related quality of life (HRQoL), a PRO, can provide data that informs economic evaluations of treatments for patients with CKD. PROMs help determine the value of different therapies by assessing their impact on patients' daily lives beyond clinical outcomes and can help policymakers make decisions about funding and reimbursement that consider the priorities and preferences of patients. Economic evaluations often employ cost-utility analyses (CUA), which use Quality-Adjusted Life Years (QALYs) as a key metric. QALYs combine both the quality and quantity of life lived, allowing for the comparison of the effectiveness of different interventions in a standardized manner. By integrating utilities derived from PROMs, these analyses quantify the benefits of CKD treatments in terms of how patients feel and function. Furthermore, PROMs contribute to quality improvement initiatives by identifying areas where patient care can be enhanced, guiding the implementation of programs that improve HRQoL while maintaining cost-effectiveness. In value-based financing environments, the integration of PROMs ensures that patient-centred outcomes are prioritized, leading to more effective and equitable healthcare delivery. In this article we will discuss the role of PROMs in economic evaluations in CKD and provide an overview of approaches for using PROMs in economic evaluations to inform decision-making in nephrology.