Economic evaluation in renal disease

The publication of economic evaluations of health interventions relevant to the practice of nephrology is increasing. These are not simply academic exercises, but an essential tool to inform optimal use of potentially costly health interventions. An overview of the necessary components of economic evaluations is provided, with expanded discussion of contemporary issues. These include how intermediate health outcomes are handled through mathematical modeling and its attendant pros and cons, the role of sensitivity analysis in harnessing uncertainty, the potential impact of bias and when it is likely to occur, as well as a discussion of how the high costs of ongoing dialysis can impact results. Greater understanding of economic evaluations and their potential pitfalls will enable appropriate interpretation, and further their use as a tool to maximize health benefits, given finite health care resources.