---
title: "Imlifidase in Kidney transplantation in highly sensitized patients: cost-effectiveness analyses and utility weights"
description: "Published cost-effectiveness analyses and health-state utility weights for Imlifidase in Kidney transplantation in highly sensitized patients, each value quoted from the article: 13 cost-effectiveness analyses and 10 studies reporting utility weights. Analyses: Kidney transplantation by donor type versus long-term dialysis in end-stage renal disease, United States: Axelrod et al. (2018); Acceptable HLA mismatch allocation versus current deceased-donor allocation in highly sensitized transplant candidates, Australia: Nguyen et al. (2014); Medicare immunosuppressive drug coverage for the duration of transplant survival versus 36-month coverage in kidney transplant recipients, United States: Kadatz et al. (2020); Kidney retransplantation versus no retransplantation after graft failure, United States: Hornberger et al. (1997); 9 further articles. Utility weights: Utility weights for a functioning and a failed kidney transplant, kidney transplant recipients: Kadatz et al. (2020); Utility weights for dialysis, kidney transplantation, graft failure, and transplant recovery, cytomegalovirus-negative kidney transplant recipients: Axelrod et al. (2022); Utility weights for dialysis before and after kidney transplant failure and successful transplantation, end-stage renal disease: Hornberger et al. (1997); Utility weights for dialysis and a functioning transplant, end-stage renal disease: Lee et al. (2009); 6 further articles. Every value is a verbatim quote from the primary article it is shown with."
canonical: "https://www.evicenter.com/drugs/imlifidase--kidney-transplantation-in-highly-sensitized-patients/cost-effectiveness-analyses"
published: "2026-10-22T07:49:06-04:00"
modified: "2026-10-22T07:49:06-04:00"
---

# Imlifidase in Kidney transplantation in highly sensitized patients: 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.

<a id="cost-effectiveness-analyses-overview"></a>

## Overview

<a id="cost-effectiveness-analyses-topic-overview-1"></a>

| Item | Detail |
| --- | --- |
| Literature searched | Tufts Medical Center Cost-Effectiveness Analysis Registry, searched October 21, 2026; the queries are listed in section 3. |
| Cost-effectiveness analyses | 13 |
| Studies reporting utility weights | 10 |

<a id="cost-effectiveness-analyses-cost-effectiveness-analyses"></a>

## 1 Cost-effectiveness analyses

<a id="cost-effectiveness-analyses-heading-1.1"></a>

### 1.1 Analyses of Imlifidase

No evidence found.

<a id="cost-effectiveness-analyses-heading-1.2"></a>

### 1.2 Treatments for the same indication

<a id="cost-effectiveness-analyses-topic-1.2-1"></a>

#### 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.”
> “Two sources were combined to estimate the healthcare resource use associated with transplantation in this analysis, which, in general, assumes a payer perspective.”
> “Both QALYs and costs were discounted to present values by using an annual rate of 3%.”
> “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).”
> “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).”
> “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.”
> “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.”
> “KDPI ≤85 DDKT KDPI >85 DDKT PHS increased risk DDKT Dialysis HLA 0-3 mismatch LDKT HLA 4-6 mismatch LDKT ABOi LDKT ILDKT”
> “Cost per QALY over 10 years Mean $49 017 $63 531 $51 922 $72 476 $39 939 $41 016 $59 564 $80 486”

Source: [Axelrod et al. (2018)](https://doi.org/10.1111/ajt.14702)

<a id="cost-effectiveness-analyses-topic-1.2-2"></a>

#### 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.

> “Using decision analytical modeling, we compared the average waiting time for transplantation, overall survival gains (in life-years and quality-adjusted life-years gained), and costs of integrating an acceptable mismatch allocation model compared with the current deceased-donor kidney allocation model in Australia.”
> “Acceptable mismatches were identified in 12 of 28 (43%) highly sensitized recipients using HLAMatchmaker.”
> “Inclusion of acceptable mismatches in the current allocation model improved the transplantation access for four (14%) highly sensitized recipients, with an average reduction in waiting time of 34 months (from 86 to 52 months).”
> “Compared with the current allocation model, incorporating an acceptable mismatch allocation model achieved an overall lifetime gain of 0.034 quality-adjusted life-years and savings of over $4,000 per highly sensitized patient, with a small consequential loss of 0.005 quality-adjusted life-years and extra costs of $800 for every reallocated patient.”

Source: [Nguyen et al. (2014)](https://pubmed.ncbi.nlm.nih.gov/24690676/)

<a id="cost-effectiveness-analyses-heading-1.3"></a>

### 1.3 The same disease in other populations or settings

<a id="cost-effectiveness-analyses-topic-1.3-1"></a>

#### 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.”
> “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.”
> “Discounting of 3% was applied to both cost and utility as per current recommendations.”
> “A lifetime time horizon was set with a 3-month cycle length and half-cycle correction.”
> “All cost estimates were adjusted to 2018 US dollars using the consumer price index.”
> “The reduction in cumulative cost with extended immunosuppressant drug coverage was $3077 per patient over the lifetime time horizon of the model”
> “with an increase in projected QALYs of 0.37, assuming a risk reduction of 15.2% in death-censored transplant loss.”
> “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.”

Source: [Kadatz et al. (2020)](https://pmc.ncbi.nlm.nih.gov/articles/PMC6934999/)

<a id="cost-effectiveness-analyses-topic-1.3-2"></a>

#### 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.”
> “Data sources include the U.S. Renal Data System (USRDS) Case-Mix Severity Study, Health Care Financing Administration (HCFA) data, and a MEDLINE search.”
> “Outcome measures include life expectancy, quality-adjusted life expectancy, lifetime costs of medical care, and marginal cost-effectiveness from a societal perspective.”
> “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.”
> “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.”

Source: [Hornberger et al. (1997)](https://pubmed.ncbi.nlm.nih.gov/9343794/)

<a id="cost-effectiveness-analyses-topic-1.3-3"></a>

#### 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.”
> “The time horizon was truncated at 40 years as most patients would have died or lost their graft by this time.”
> “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%.”
> “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.”
> “However, benefits from reduced graft loss were eliminated if there was a small increased risk of death from added therapy.”
> “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.”
> “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).”
> “0.65 risk reduction No Screen 439 486 12.281 Screen 448 467 12.327 8981 0.0707 127 120”

Source: [Kiberd et al. (2016)](https://doi.org/10.1111/ajt.13838)

<a id="cost-effectiveness-analyses-topic-1.3-4"></a>

#### 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

> “A Markov model was developed to examine the cost-effectiveness of hemodialysis and renal transplant over a 5-year time horizon from the payer perspective, using empirical data on treatment costs from private hospitals in Dubai, utilities from Tufts Cost-Effectiveness Analysis Registry, and transition probabilities from European Renal Association-European Dialysis and Transplant Association registry data.”
> “Analysis was performed with time horizons of 1, 2, 3, 4, and 5 years.”
> “The annual discount rate was 3% for both costs and outcomes.”
> “In the base-case analysis, the discounted average total cost for 5 years was AED 961, 323 ($261 941) for transplantation and AED 971 538 ($264 724) for hemodialysis, with 3.4 and 2.1 quality-adjusted life years (QALY), respectively.”
> “Transplantation became the dominant treatment strategy by the fourth year and was a cost-effective alternative from the second year on with an incremental cost-effectiveness ratio of AED 53 205 ($14 497 per QALY) (for a cost difference of AED 36 712 ($10 003) and QALY gain of 0.69).”

Source: [Soni et al. (2025)](https://doi.org/10.1016/j.vhri.2025.101109)

| Year | ICER (AED) |
| --- | --- |
| “Year 0” | “1 077 778” |
| “Year 1” | “298 364” |
| “Year 2” | “53 206” |
| “Year 3” | “−23 356” |
| “Year 4” | “−7622” |

Source: [Soni et al. (2025)](https://doi.org/10.1016/j.vhri.2025.101109)

<a id="cost-effectiveness-analyses-topic-1.3-5"></a>

#### 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.”
> “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.”
> “Model parameters and costs were estimated using data from the Medicare population and a large integrated health-care delivery system between 1996 and 2003.”
> “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.”
> “Higher incremental cost-effectiveness ratios were associated with older age and more comorbid conditions.”

Source: [Lee et al. (2009)](https://pubmed.ncbi.nlm.nih.gov/19911442/)

<a id="cost-effectiveness-analyses-topic-1.3-6"></a>

#### 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.”
> “For health–utility analyses, 36-item Short Form Health Survey (SF-36) data were converted to the 6-dimension Short Form (SF-6D).”
> “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).”
> “the expected cost for the first year after transplantation is €62 551.”
> “For patients on the waiting list, the expected cost is estimated to be €52 476.”
> “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.”
> “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).”

Source: [Heldal et al. (2019)](https://pmc.ncbi.nlm.nih.gov/articles/PMC6885668/)

<a id="cost-effectiveness-analyses-topic-1.3-7"></a>

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

Relevance: Evaluates kidney transplantation against dialysis in Denmark.

> “The objective of this study was to estimate the cost-effectiveness of kidney transplantation versus dialysis from a public health-care perspective.”
> “A cost-utility analysis was conducted using a decision analytic model.”
> “The model was designed as a Markov model in which all relevant costs and effects of the two alternative treatments were included.”
> “The cost per quality-adjusted life year (QALY) was 1,032,934 DKK for dialysis compared with 810,516 DKK for transplantation.”
> “When comparing kidney transplantation with dialysis, kidney transplantation was cost-saving and resulted in additional QALYs.”
> “In addition, a cost-effectiveness acceptability curve showed that transplantation had a 99.93% likelihood of being cost-effective at a willingness-to-pay value of 0 DKK.”

Source: [Jensen et al. (2014)](https://pubmed.ncbi.nlm.nih.gov/24814915/)

<a id="cost-effectiveness-analyses-topic-1.3-8"></a>

#### 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).”
> “A prospective, descriptive study of cost and efficacy was performed in the Hospital Clinic in Barcelona from January to December 2011.”
> “We included 106 patients (57 undergoing HD and 49 receiving a LDKT).”
> “The total cost of LDKT was €29,897.91 (€8,128.44 for donors and €21,769.47 for recipients).”
> “The total cost of HD was €43,000.88 (€37,917 for HD and related procedures plus €5,082 for transport).”
> “LDKT represented a savings of €13,102.97 per patient/year and the payback period was less than 1 year.”
> “Quality-adjusted life years were higher in LDKT than in HD patients.”

Source: [Sánchez-Escuredo et al. (2015)](https://pubmed.ncbi.nlm.nih.gov/25645763/)

<a id="cost-effectiveness-analyses-topic-1.3-9"></a>

#### 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.

> “A Markov model was constructed to evaluate costs and effects of two different clinical strategies on a simulated cohort of 1,000 transplant recipients: serological screening (SS) only and flow screening (FS) only.”
> “Outcomes measures were total cost of patient care over 25 years, life expectancy, quality-adjusted life expectancy, and transplant life expectancy.”
> “In the base-case analysis, FS was associated with an average gain of 0.08 life years, 0.25 transplant life years, and 0.08 quality-adjusted life years per patient.”
> “SS was associated with a higher cost of CND$6,397 per patient, mostly because of increased use of dialysis in patients who suffered early graft loss under the SS strategy.”
> “Routine use of FS in recipients of first-deceased donor kidney transplants is cost-effective.”

Source: [McLaughlin et al. (2006)](https://pubmed.ncbi.nlm.nih.gov/16699455/)

<a id="cost-effectiveness-analyses-topic-1.3-10"></a>

#### 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.”
> “A three-state Markov model was applied to estimate cost-effectiveness to 10 years post-transplant.”
> “Total mean treatment cost per patient to year 1 post-transplant was €62 075 vs. €59 767 for rATG versus basiliximab (P < 0.01).”
> “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.”
> “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.”
> “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.”

Source: [Cremaschi et al. (2017)](https://pubmed.ncbi.nlm.nih.gov/28556488/)

<a id="cost-effectiveness-analyses-topic-1.3-11"></a>

#### 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.”
> “Model simulations were run over a 20-y time horizon.”
> “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.”
> “Foregoing kidneys from these donors incurred total costs of $330 517 and a gain of 8.44 QALYs.”
> “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.”
> “Probabilistic sensitivity analysis using 10 000 iterations showed accepting kidneys from donors at increased risk led to lower costs and higher QALY gains.”

Source: [Shah et al. (2023)](https://pubmed.ncbi.nlm.nih.gov/37211651/)

<a id="cost-effectiveness-analyses-heading-1.4"></a>

### 1.4 Related diseases and analogous treatments

No evidence found.

<a id="cost-effectiveness-analyses-utility-weights"></a>

## 2 Utility weights

<a id="cost-effectiveness-analyses-heading-2.1"></a>

### 2.1 Utility weights from analyses of Imlifidase

No evidence found.

<a id="cost-effectiveness-analyses-heading-2.2"></a>

### 2.2 Utility weights for the same indication

No evidence found.

<a id="cost-effectiveness-analyses-heading-2.3"></a>

### 2.3 Utility weights for the same disease in other populations or settings

<a id="cost-effectiveness-analyses-topic-2.3-1"></a>

#### Utility weights for a functioning and a failed kidney transplant, kidney transplant recipients: Kadatz et al. (2020)

Relevance: Utilities for a functioning kidney transplant and a failed transplant, taken from the literature for a model of Medicare-insured United States recipients.

> “The utility estimates for patients on dialysis and with a functioning transplant in QALYs were extracted from the literature.”

Source: [Kadatz et al. (2020)](https://pmc.ncbi.nlm.nih.gov/articles/PMC6934999/)

| Health state | Utility |
| --- | --- |
| “Alive with a functioning transplant” | “0.82 (0.74–0.90)” |
| “Alive with a failed transplant” | “0.67 (0.64–0.71)” |

Source: [Kadatz et al. (2020)](https://pmc.ncbi.nlm.nih.gov/articles/PMC6934999/)

<a id="cost-effectiveness-analyses-topic-2.3-2"></a>

#### 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.

> “To assess the long-term survival and economic benefits of allocation policy reforms, a decision-analytic model was constructed to compare receipt of CMV D- with CMV D+ organ in CMV R- recipients using data from transplant registry, Medicare claims, and pharmaceutical costs.”

Source: [Axelrod et al. (2022)](https://pubmed.ncbi.nlm.nih.gov/34310099/)

<a id="cost-effectiveness-analyses-topic-2.3-3"></a>

#### 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.

Source: [Hornberger et al. (1997)](https://pubmed.ncbi.nlm.nih.gov/9343794/)

<a id="cost-effectiveness-analyses-topic-2.3-4"></a>

#### 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.

Source: [Lee et al. (2009)](https://pubmed.ncbi.nlm.nih.gov/19911442/)

<a id="cost-effectiveness-analyses-topic-2.3-5"></a>

#### 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.

> “A theoretical cohort of adult Australian and New Zealand kidney transplant candidates on the waitlist.”
> “Markov microsimulation model, health system perspective and over a lifetime horizon.”

Source: [Ying et al. (2020)](https://pubmed.ncbi.nlm.nih.gov/31810731/)

<a id="cost-effectiveness-analyses-topic-2.3-6"></a>

#### 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.

> “A Markov model was developed to estimate costs and health outcomes [survival (life years saved, LYS) and quality-adjusted survival (QALYs)] for the alternative strategies.”

Source: [Morton et al. (2009)](https://pubmed.ncbi.nlm.nih.gov/19377055/)

<a id="cost-effectiveness-analyses-topic-2.3-7"></a>

#### 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.

Source: [Shah et al. (2023)](https://pubmed.ncbi.nlm.nih.gov/37211651/)

<a id="cost-effectiveness-analyses-topic-2.3-8"></a>

#### Utility weights for kidney transplantation and dialysis, deceased donor kidney recipients: Senanayake et al. (2020)

Relevance: Utilities for kidney transplantation and dialysis in deceased donor kidney recipients, from a model with a healthcare payer perspective.

Access: Free full text

> “Models were simulated in 1-year cycles for a 20-year time horizon, with transitions through distinct health states relevant to the kidney recipient from the healthcare payer’s perspective.”
> “In the absence of Australian sourced quality of life utility scores for patients on dialysis or with a kidney transplant, we extrapolated utility scores from a systematic review and meta-analysis.”
> “The utility score among patients with a transplant was estimated to be 0.82 (95% CI [confidence interval] 0.74-0.90), while that among patients on dialysis was 0.70 (95% CI 0.62-0.78), without differentiating between the different dialysis modalities.”

Source: [Senanayake et al. (2020)](https://doi.org/10.1016/j.jval.2020.07.007)

<a id="cost-effectiveness-analyses-topic-2.3-9"></a>

#### 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

> “The utilities to estimate QALY in each health state were obtained from a literature review using the Tufts CEA registry”

Source: [Soni et al. (2025)](https://doi.org/10.1016/j.vhri.2025.101109)

| Health state | Utility |
| --- | --- |
| “Hemodialysis” | “0.55” |
| “Transplant” | “0.72” |

Source: [Soni et al. (2025)](https://doi.org/10.1016/j.vhri.2025.101109)

<a id="cost-effectiveness-analyses-topic-2.3-10"></a>

#### 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.

Source: [McLaughlin et al. (2006)](https://pubmed.ncbi.nlm.nih.gov/16699455/)

<a id="cost-effectiveness-analyses-heading-2.4"></a>

### 2.4 Utility weights for related diseases and analogous treatments

No evidence found.

<a id="cost-effectiveness-analyses-search-strategy"></a>

## 3 Search strategy

<a id="cost-effectiveness-analyses-topic-3-1"></a>

| Dataset | Query | Results |
| --- | --- | --- |
| Methods | imlifidase OR IdeS OR Idefirix | 1 |
| Ratios | desensitization 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 |

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