Researcher Spotlight: Giving a Voice to Patients Through Health Outcomes Research

Working at a pharmaceutical company was a natural next step in Nabin Poudel’s career journey after earning his bachelor’s degree in pharmacy and his master’s in business administration. What he didn’t expect during that job was to witness firsthand a weakness within the health care system that would lead him to pursue his PhD in health outcomes research.

In his role, Poudel interacted with both physicians and patients. The doctors would tell him that the patients were not taking their medications as prescribed, while the patients would complain that the doctors weren’t considering their preferences when prescribing medications.

“This was a very pivotal moment for me that drew my interest into the field of health outcomes research, where I want to bridge the gap between what patients want or need and what doctors are prescribing,” he said.

Poudel earned his PhD from Auburn University and is now a postdoctoral fellow at the University of Maryland, Baltimore. He received a 2024 PhRMA Foundation Postdoctoral Fellowship in the Value Assessment and Health Outcomes Research for his project aiming to better integrate patient preferences when assessing the value of health care interventions.

Poudel will evaluate the value of different methods for monitoring kidney health after a transplant as a case study for testing a new value assessment approach.

In the United States, about 28,000 patients undergo kidney transplantation each year, but
10% to 15% of patients experience kidney transplant rejection. There are several options for monitoring kidney health, and patients may prefer one option over another based on factors such as convenience, cost, and efficacy.

But when researchers assess the value of such health care interventions, they typically compare costs and health benefits, while patient preferences are often overlooked. For instance, a commonly used metric for value assessment is quality-adjusted life years (QALYs), which accounts for improvements in length of life and quality of life. However, this approach can potentially discriminate against those with disabilities and doesn’t account for patient preferences.

As such, Poudel’s value assessment approach will use an alternative metric called health years in total (HYT), which aims to address some of the concerns with the QALY, and then incorporate information on patient preferences. “This patient-centric approach can be used by health care providers to help with treatment decisions and by regulatory agencies to aid in reimbursement decisions,” Poudel said. “This approach could lead to improved health outcomes for patients and ensure that limited resources are used in an efficient and fair way.”

This postdoctoral fellowship is Poudel’s second award from the PhRMA Foundation. In 2023, he was first author on a paper in the Journal of Managed Care & Specialty Pharmacy (JMCP) that received a $25,000 Challenge Award. This award honored manuscripts that explored crucial challenges facing the Centers for Medicare & Medicaid Services (CMS) in implementing Medicare drug price negotiation.

Poudel’s paper addressed the issue of patient engagement in the CMS process. The paper proposed a four-step process to implement a patient-centered framework to systematically evaluate treatment benefits. “The involvement of patients in the evidence evaluation process ensures that patients’ perspectives and needs are considered, resulting in more patient-centered decision-making,” the paper states.

Poudel’s career goal is to become an independent researcher in the field of patient preferences and value assessment research. “I aim to develop a novel methodology that will incorporate the patient voice into the health care decision-making process,” he said.

Learn more about the PhRMA Foundation’s fellowship and grant opportunities. Check out more researcher stories on our blog.