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Imlifidase

Kidney transplantation in highly sensitized patients

Manufacturer
Hansa Biopharma
Last updated
85 sources

Cost-effectiveness analyses and utility weights

Published cost-effectiveness analyses and health-state utility weights that a model of this product could cite, adapt, or compare against, grouped by how each article relates to the product and its indication. Every value is quoted from the article it cites, and section 3 lists the searches that found the articles.

13 cost-effectiveness analyses and 10 studies reporting utility weights · 17 sources

Overview

ItemDetail
Literature searchedTufts Medical Center Cost-Effectiveness Analysis Registry, searched October 21, 2026; the queries are listed in section 3.
Cost-effectiveness analyses13
Studies reporting utility weights10

Cost-effectiveness analyses

Analyses of Imlifidase

No evidence found.

Treatments for the same indication

Kidney transplantation by donor type versus long-term dialysis in end-stage renal disease, United States: Axelrod et al. (2018)

Relevance: Evaluates HLA-incompatible and ABO-incompatible living donor kidney transplantation, among other donor categories, against long-term dialysis in the United States; dialysis is the comparator of the Irish imlifidase model in section 4.1.

Access: Free full text

“The costs of transplantation and dialysis were compared with the use of discrete event simulation over a 10-year period, with data from the United States Renal Data System, University HealthSystem Consortium, and literature review.” (opens the source at this quote in a new tab)

“Two sources were combined to estimate the healthcare resource use associated with transplantation in this analysis, which, in general, assumes a payer perspective.” (opens the source at this quote in a new tab)

“Both QALYs and costs were discounted to present values by using an annual rate of 3%.” (opens the source at this quote in a new tab)

“All transplantation options were associated with improved survival compared with dialysis (transplantation: 5.20-6.34 quality-adjusted life-years [QALYs] vs dialysis: 4.03 QALYs).” (opens the source at this quote in a new tab)

“Living donor and low-KDPI deceased donor transplantations were cost-saving compared with dialysis, while transplantations using high-KDPI deceased donor, ABO-incompatible or HLA-incompatible living donors were cost-effective (<$100 000 per QALY).” (opens the source at this quote in a new tab)

“Maintenance dialysis costs were estimated at $72 476 per QALY over 10 years. HLA-compatible, well-matched LDKT provided the most cost-effective form of renal replacement therapy. LDKTs were predicted to be 45% less expensive than dialysis ($39 939 per QALY). Despite being more expensive initially, ABOi transplantation was associated with a lower mean cost per QALY than dialysis ($59 564). ILDKT, however, was associated with a slightly higher cost per QALY ($80 486 per QALY) than dialysis over 10 years.” (opens the source at this quote in a new tab)

“Deceased donor transplantation with a low-KDPI organ was estimated to be more cost-effective than dialysis ($49 017 vs $72 376 per QALY) but 23% more costly than LDKT. Despite higher initial expenses and shorter survival, transplantation with high-KPDI DDKT ($63 531 per QALY) costs 12.2% less per QALY than dialysis.” (opens the source at this quote in a new tab)

“KDPI ≤85 DDKT KDPI >85 DDKT PHS increased risk DDKT Dialysis HLA 0-3 mismatch LDKT HLA 4-6 mismatch LDKT ABOi LDKT ILDKT” (opens the source at this quote in a new tab)

“Cost per QALY over 10 years Mean $49 017 $63 531 $51 922 $72 476 $39 939 $41 016 $59 564 $80 486” (opens the source at this quote in a new tab)

Acceptable HLA mismatch allocation versus current deceased-donor allocation in highly sensitized transplant candidates, Australia: Nguyen et al. (2014)

Relevance: Evaluates an acceptable HLA mismatch allocation program for highly sensitized transplant candidates, a standard-of-care approach listed in section 2 under compatible donor allocation and acceptable mismatch programs.

The same disease in other populations or settings

Medicare immunosuppressive drug coverage for the duration of transplant survival versus 36-month coverage in kidney transplant recipients, United States: Kadatz et al. (2020)

Relevance: Evaluates extending Medicare coverage of immunosuppressive drugs for kidney transplant recipients in the United States, the maintenance immunosuppression that follows an imlifidase-enabled transplant.

“In this cost-effectiveness analysis, we used a Markov model to simulate a fixed cohort of Medicare-insured adult kidney transplant recipients aged 18–62 years who survived with a functioning transplant for at least 36 months.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

“The primary model compares the strategy of extending immunosuppression coverage for the lifetime of the kidney transplant to the current policy of discontinuing immunosuppression coverage at 36 months after transplantation from the perspective of Medicare as a health care payer.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

“Discounting of 3% was applied to both cost and utility as per current recommendations.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

“A lifetime time horizon was set with a 3-month cycle length and half-cycle correction.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

“All cost estimates were adjusted to 2018 US dollars using the consumer price index.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

“The reduction in cumulative cost with extended immunosuppressant drug coverage was $3077 per patient over the lifetime time horizon of the model” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

“with an increase in projected QALYs of 0.37, assuming a risk reduction of 15.2% in death-censored transplant loss.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

“a scenario with only 50% of observed benefit (risk reduction of 7.6% in death-censored transplant loss) had an incremental increase in cost of $9728 and an ICUR of $51,694/ QALY gained.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

Kidney retransplantation versus no retransplantation after graft failure, United States: Hornberger et al. (1997)

Relevance: Evaluates the availability of repeat kidney transplantation after graft failure in the United States, with dialysis and functioning-graft states that a lifetime model of transplantation in sensitized candidates would use.

“Specifically, the analysis examines the effect on transplant candidates of having the option of kidney retransplantation, if and when retransplantation might be needed.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“Data sources include the U.S. Renal Data System (USRDS) Case-Mix Severity Study, Health Care Financing Administration (HCFA) data, and a MEDLINE search.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“Outcome measures include life expectancy, quality-adjusted life expectancy, lifetime costs of medical care, and marginal cost-effectiveness from a societal perspective.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“By avoiding lifelong dialysis after graft failure, first-transplant candidates gain an average of 47 quality-adjusted days with a retransplantation policy, despite the prolongation of time to first transplant by an average of 30 quality-adjusted days.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“The lifetime cost of medical care per first-transplant candidate is $1,210 higher with a retransplantation policy compared with the no-retransplantation policy; its societal cost-effectiveness is estimated to be $9,656 per quality-adjusted life-year saved.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

Annual screening for de novo donor-specific antibodies versus no screening in kidney transplant recipients after the first year, United States: Kiberd et al. (2016)

Relevance: Evaluates annual screening for de novo donor-specific HLA antibodies in kidney transplant recipients in the United States, the class of antibodies that imlifidase cleaves before transplantation.

Access: Free full text

“A medical decision analysis to examine a screening strategy was developed for kidney transplant recipients who had stable graft function and were DSA negative 1 year posttransplant.” (opens the source at this quote in a new tab)

“The time horizon was truncated at 40 years as most patients would have died or lost their graft by this time.” (opens the source at this quote in a new tab)

“Probabilities and costs were taken from the literature, from Medicare payment schedules, and pharmacy sources and are presented from a Medicare third-party perspective in constant 2013 US dollars (Table 1 and Data S1). In a cost-effective analysis, costs and outcomes were discounted at 3%.” (opens the source at this quote in a new tab)

“In the base case, a modest 25% reduction in graft loss in dnDSA–positive patients treated with increased immunosuppression resulted in 0.04618 quality-adjusted years (QALYs) gained.” (opens the source at this quote in a new tab)

“However, benefits from reduced graft loss were eliminated if there was a small increased risk of death from added therapy.” (opens the source at this quote in a new tab)

“The incremental cost effectiveness was marginal at approximately $120 000–250 000 per QALY, but could be more or less favorable depending on several key variables such as efficacy of treatment, screening costs, incidence rate of subclinical dnDSA, and patient survival.” (opens the source at this quote in a new tab)

“In the baseline model, the incremental costs per QALY were relatively high with screening at $207 066 per QALY. Better efficacy was associated with more favorable incremental cost effectiveness (Table 2).” (opens the source at this quote in a new tab)

“0.65 risk reduction No Screen 439 486 12.281 Screen 448 467 12.327 8981 0.0707 127 120” (opens the source at this quote in a new tab)

Kidney transplantation versus hemodialysis in end-stage renal disease, United Arab Emirates: Soni et al. (2025)

Relevance: Evaluates kidney transplantation against hemodialysis for end-stage renal disease from a health care payer perspective in the United Arab Emirates, the transplant-versus-dialysis comparison underlying the report's economic section.

Access: Free full text

Current dialysis practice versus less costly alternatives and no dialysis in end-stage renal disease, United States: Lee et al. (2009)

Relevance: Evaluates the incremental cost-effectiveness of dialysis for end-stage renal disease in the United States, the maintenance dialysis that section 2 lists as the alternative for candidates who remain untransplanted.

Access: Free full text

Not quoted: The results for the comparisons among the less costly alternatives and no dialysis are reported in the full text, which the publisher provides as a PDF that this page does not quote.

“We developed a computer simulation model for the end-stage renal disease population and compared cost, life expectancy, and quality adjusted life expectancy of current dialysis practice relative to three less costly alternatives and to no dialysis.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“We estimated incremental cost-effectiveness ratios for these alternatives relative to the next least costly alternative and no dialysis and analyzed the population distribution of the ratios.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“Model parameters and costs were estimated using data from the Medicare population and a large integrated health-care delivery system between 1996 and 2003.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“The incremental cost-effectiveness ratio of dialysis of current practice relative to the next least costly alternative is on average $129,090 per quality-adjusted life-year (QALY) ($61,294 per year), but its distribution within the population is wide; the interquartile range is $71,890 per QALY, while the 1st and 99th percentiles are $65,496 and $488,360 per QALY, respectively.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“Higher incremental cost-effectiveness ratios were associated with older age and more comorbid conditions.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

Kidney transplantation versus remaining on the waiting list in candidates aged 65 years or older, Norway: Heldal et al. (2019)

Relevance: Evaluates kidney transplantation against remaining on the waiting list for older candidates accepted for transplantation in Norway, with utilities from SF-6D.

“Data were retrieved from a study database (QUESTION65) including 289 patients ≥65 years of age who were accepted for kidney transplantation at the Norwegian national transplant centre at Oslo University Hospital.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

“For health–utility analyses, 36-item Short Form Health Survey (SF-36) data were converted to the 6-dimension Short Form (SF-6D).” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

“The first year on the waiting list represents 0.686 ± 0.11 QALYs compared with 0.710 ± 0.14 QALYs for the first year post-transplant (P = 0.047).” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

“the expected cost for the first year after transplantation is €62 551.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

“For patients on the waiting list, the expected cost is estimated to be €52 476.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

“The cost per QALY for the first year after transplantation is consequently €62 551/0.710 = €88 100 compared with €52 476/0.686 = €76 495 for the first year on the waiting list.” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

“According to these figures, the ICER for 1 year after transplantation is (62 551–52 476)/(0.710–0.686) = €419 792/QALY (i.e. the cost for each QALY gained by transplantation).” (opens the original PMC page at this quote in a new tab)View highlighted excerpt for this quote

Kidney transplantation versus dialysis in end-stage renal disease, Denmark: Jensen et al. (2014)

Relevance: Evaluates kidney transplantation against dialysis in Denmark.

Living-donor kidney transplantation versus hemodialysis in the first year of treatment, Spain: Sánchez-Escuredo et al. (2015)

Relevance: Evaluates living-donor kidney transplantation against hemodialysis in Spain.

“This study aimed to compare the cost of living-donor kidney transplantation (LDKT) during the first year after transplantation with that of hemodialysis (HD).” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“A prospective, descriptive study of cost and efficacy was performed in the Hospital Clinic in Barcelona from January to December 2011.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“We included 106 patients (57 undergoing HD and 49 receiving a LDKT).” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“The total cost of LDKT was €29,897.91 (€8,128.44 for donors and €21,769.47 for recipients).” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“The total cost of HD was €43,000.88 (€37,917 for HD and related procedures plus €5,082 for transport).” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“LDKT represented a savings of €13,102.97 per patient/year and the payback period was less than 1 year.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“Quality-adjusted life years were higher in LDKT than in HD patients.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

Flow cytometry crossmatching and solid-phase screening versus serological screening in recipients of primary deceased donor kidney transplants, Canada: McLaughlin et al. (2006)

Relevance: Evaluates routine flow cytometry crossmatching and solid-phase screening against serological screening in recipients of primary deceased donor kidney transplants in Canada, the crossmatch testing on which the Highdes primary endpoint of crossmatch conversion depends.

Rabbit antithymocyte globulin versus basiliximab induction after kidney transplantation, Germany: Cremaschi et al. (2017)

Relevance: Evaluates rabbit antithymocyte globulin induction against basiliximab after kidney transplantation in Germany, the induction agent given with imlifidase in the ConfIdeS trial.

“A health economic analysis was undertaken based on the 1-year database from a randomized study of rabbit anti-human thymocyte immunoglobulin (rATG) versus basiliximab, in kidney transplantation using resource utilization data and cost estimates from three German hospitals.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“A three-state Markov model was applied to estimate cost-effectiveness to 10 years post-transplant.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“Total mean treatment cost per patient to year 1 post-transplant was €62 075 vs. €59 767 for rATG versus basiliximab (P < 0.01).” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“rATG therapy was associated with similar treatment costs to basiliximab by year 2, and a predicted cumulative treatment cost saving of €4 259 under rATG versus basiliximab by year 10 post-transplant.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“The mean number of quality-adjusted life years (QALYs) per patient by year 1 was 0.809 vs. 0.802 in the rATG and basiliximab cohorts, respectively (P = 0.38), with cumulative QALYs of 6.161 and 6.065 per patient by year 10.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“By year 2, the cumulative cost per QALY was slightly lower under rATG (€35 378) than basiliximab (€35 885), progressing to a saving of €1 041 under rATG for the cumulative cost per QALY by year 10.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

Accepting versus declining kidneys from donors at increased risk of blood-borne virus transmission, Australia: Shah et al. (2023)

Relevance: Evaluates accepting kidneys from donors at increased risk of blood-borne virus transmission against current practice in Australia, a donor-pool strategy for candidates on the kidney transplant waiting list.

“A Markov model was developed using real-world evidence to compare healthcare costs and quality-adjusted life years (QALYs) of accepting kidneys from deceased donors with potential increased risk of BBV transmission, because of increased risk behaviors and/or history of HCV, versus declining these kidneys.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“Model simulations were run over a 20-y time horizon.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“Accepting kidneys from donors at increased risk of BBVs (2% from donors with increased-risk behaviors and 5% from donors with active or past HCV infection) incurred total costs of 311 303 Australian dollars with a gain of 8.53 QALYs.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“Foregoing kidneys from these donors incurred total costs of $330 517 and a gain of 8.44 QALYs.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“A cost-saving of $19 214 and additional 0.09 QALYs (~33 d in full health) per person would be generated compared with declining these donors.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

“Probabilistic sensitivity analysis using 10 000 iterations showed accepting kidneys from donors at increased risk led to lower costs and higher QALY gains.” (opens the original PubMed page at this quote in a new tab)View highlighted excerpt for this quote

Related diseases and analogous treatments

No evidence found.

Utility weights

Utility weights from analyses of Imlifidase

No evidence found.

Utility weights for the same indication

No evidence found.

Utility weights for the same disease in other populations or settings

Utility weights for dialysis, kidney transplantation, graft failure, and transplant recovery, cytomegalovirus-negative kidney transplant recipients: Axelrod et al. (2022)

Relevance: Utilities for dialysis and kidney transplant, with disutilities for a graft failure episode and transplant recovery, from a United States kidney transplant model.

Access: Not open access

Not quoted: The utility weights are reported in the full text, which is closed access.

Utility weights for dialysis before and after kidney transplant failure and successful transplantation, end-stage renal disease: Hornberger et al. (1997)

Relevance: Utilities for dialysis before transplant, dialysis after a failed first or repeat transplant, and a successful transplant, from a United States model.

Access: Not open access

Not quoted: The utility weights are reported in the full text, which is closed access.

Utility weights for dialysis and a functioning transplant, end-stage renal disease: Lee et al. (2009)

Relevance: Utilities for dialysis and for a functioning transplant in end-stage renal disease, from a United States model.

Access: Free full text

Not quoted: The utility weights are reported in the full text, which the publisher provides as a PDF that this page does not quote.

Utility weights for the transplant waiting list, dialysis, and transplantation, waitlisted kidney transplant candidates: Ying et al. (2020)

Relevance: Utilities for the transplant waiting list, dialysis, and transplantation, from a lifetime health system model of Australian and New Zealand kidney transplant candidates on the waitlist.

Access: Not open access

Not quoted: The utility weights are reported in the full text, which is closed access.

Utility weights for a functioning transplant, acute rejection, induction adverse effects, and dialysis, kidney transplant recipients: Morton et al. (2009)

Relevance: Utilities for a functioning transplant, acute rejection, induction drug adverse effects, and dialysis in kidney transplant recipients.

Access: Not open access

Not quoted: The utility weights are reported in the full text, which is closed access.

Utility weights for the kidney transplant waiting list and graft function states, kidney transplant candidates and recipients: Shah et al. (2023)

Relevance: Utilities for the kidney transplant waiting list and for graft function states, from an Australian model of accepting kidneys from donors at increased risk of blood-borne virus transmission.

Access: Not open access

Not quoted: The utility weights are reported in the full text, which is closed access.

Utility weights for hemodialysis and kidney transplantation, end-stage renal disease: Soni et al. (2025)

Relevance: Utilities for hemodialysis and kidney transplant in end-stage renal disease.

Access: Free full text

Utility weights for dialysis and renal transplantation, end-stage renal disease: McLaughlin et al. (2006)

Relevance: Utilities for dialysis and renal transplantation from a model of immunological screening before deceased donor transplantation.

Access: Not open access

Not quoted: The utility weights are reported in the full text, which is closed access.

Utility weights for related diseases and analogous treatments

No evidence found.

Search strategy

DatasetQueryResults
Methodsimlifidase OR IdeS OR Idefirix1
Ratiosdesensitization OR "highly sensitized" OR "incompatible" OR "HLA-incompatible"36
Ratios"kidney transplant" OR "kidney transplantation" OR "renal transplant" OR "renal transplantation"224
Ratios"paired exchange" OR "paired donation" OR "kidney exchange" OR "antibody-mediated rejection" OR "plasmapheresis" OR "plasma exchange"31
Weights"kidney transplant" OR "renal transplant" OR "functioning graft" OR "graft failure"338
Weights"antibody-mediated rejection" OR "acute rejection" OR "transplant rejection" OR "waiting list" OR "waitlist"336
Weights"end-stage renal disease" AND (dialysis OR hemodialysis)256