Health Technology Assessment in nephrology and dialysis

Abstract

The nephrology and dialysis sector is characterized by a high technological content, considerable technological and digital complexity, continuous innovation within the care processes and a strong economic impact on the national and regional health system. The purpose of this article is to illustrate the application of the Health Technology Assessment (HTA) methodology in the evaluation of technological innovations in the nephrology and dialysis field. In particular, the evaluation steps of the multidimensional and multidisciplinary process applied to the nephrodialysis field will be described, specifically a device to be used in patients with chronic kidney disease, also considering important comorbidities such as cardiomyopathies and arrhythmias, which often require implantation of electronic cardiac implantable devices in renal patients. The HTA uses a rigorous scientific methodology, and today represents an essential tool for a governance of the modern health system, in which every innovative technological element that significantly modifies the organization must be evaluated. For this strategic reason, HTA becomes an important intervention for the dialysis sector, where technological innovations are a fundamental sector. For a precise understanding of the function of HTA in dialysis, a complete example of the application of HTA for the evaluation of a resorbable antibacterial device for the prevention of infections from cardiac implantable electronic devices on patients with high infectious risk has been shown, such as patients with chronic kidney disease.