Estimation of Health State Utility Values for Immunoglobulin A Nephropathy: A Time Trade-Off Analysis
Topics: Nephrology IgAN Non-product HEOR Publication Summary
Zhou ZY, Bensink ME, Hazra NC et al.
10.1007/s41669-024-00527-1
Summary
Estimating health state utility values for IgA nephropathy1
Background
IgA nephropathy is a rare, progressive kidney disorder marked by immune complex deposition in the glomerular mesangium, leading to proteinuria, chronic kidney disease (CKD), and ultimately kidney failure.1-3 Proteinuria is not only a hallmark symptom but a validated surrogate endpoint and driver of poor health-related quality of life (HRQoL) in IgA nephropathy.1-4
Aim
This study aimed to estimate health state utility values in IgA nephropathy based on CKD stages, proteinuria levels, dialysis status, and presence of nephrotic syndrome.1
Approach
This vignette-based, cross-sectional study used a time trade-off (TTO) interview approach from the perspective of a United Kingdom (UK) general population (n=200).1 Health states were based on CKD stage (1–5), proteinuria (<1 g/day or ≥1 g/day), dialysis use, and presence of nephrotic syndrome. Utility values were derived using the standard EuroQol Valuation Technology (EQ-VT) protocol.1
Findings
Estimated health state utility values showed a trend of decline with worsening CKD progression and elevated proteinuria1
Within CKD stages 1-4, proteinuria had a pronounced effect on health utility.1 Proteinuria ≥1 g/day led to a mean utility decrement of 0.09, ranging from 0.06 in CKD stage 4 to 0.13 in CKD stage 1/2, suggesting that proteinuria had a larger impact on utility in lower CKD stages.1 Mean utility values for nephrotic syndrome suggest that nephrotic syndrome has a larger impact on utility in lower CKD stages.1 CKD stage 5 had a lower utility value than the other stages, resulting in a utility decrement of 0.04 associated with dialysis (P<0.0001).1
Mean (Standard Deviation [SD]) TTO Utility Values1
CKD stage 1/2:
- Proteinuria <1 g/day: 0.84 (0.17), n=170
- Proteinuria ≥1 g/day: 0.71 (0.23), n=184
- Nephrotic syndrome disutility: 0.43 (0.31), n=170
CKD stage 3:
- Proteinuria <1 g/day: 0.68 (0.23), n=154
- Proteinuria ≥1 g/day: 0.61 (0.25), n=185
- Nephrotic syndrome disutility: 0.28 (0.25), n=154
CKD stage 4:
- Proteinuria <1 g/day: 0.55 (0.26), n=140
- Proteinuria ≥1 g/day: 0.49 (0.27), n=185
- Nephrotic syndrome disutility: 0.17 (0.24), n=140
CKD stage 5:
- Non-dialysis: 0.42 (0.28), n=137
- Dialysis: 0.38 (0.30), n=179
Key takeaway
To the best of the authors’ knowledge, this study offers the first estimated IgA nephropathy‑specific health state utility values, emphasizing that elevated proteinuria and nephrotic syndrome carry substantial burdens on quality of life.1 These health state utility values are critical inputs for economic evaluation in nephrology and underscore the clinical utility of therapies that reduce proteinuria and delay CKD progression in IgA nephropathy.1
Footnotes
This study was funded by Travere Therapeutics, Inc. Please see the publication for the full list of disclosures.
CKD, chronic kidney disease; EQ-VT, EuroQol Valuation Technology; HRQoL, health-related quality of life; QoL, quality of life; TTO, time trade-off; UK, United Kingdom
- Zhou ZY et al. Pharmacoecon Open. 2024;9(1):83–92.
- Rajasekaran A et al. Am J Med Sci. 2020;361(2):176–194.
- Kwon CS et al. J Health Econ Outcomes Res. 2021;8(2):36–45.
- Thompson A et al. Clin J Am Soc Nephrol. 2019;14(3):469–481.
MA-DS-25-0061 | July 2025