ArticleAdvances in therapy2026
Difelikefalin Treatment in Chronic Kidney Disease-Associated Pruritus: Modelling Infection-Related Hospitalisation Cost Offsets Using Trial and Real-World Data Across Seven European Countries.
Article in Advances in therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionWe estimated cost offsets from treating moderate-to-severe chronic kidney disease-associated pruritus (CKD-aP) with difelikefalin, through reduced infection-related hospitalisations (IRHs).
methodsUsing Stockholm CREAtinine Measurements study data, IRH rates were estimated for patients who developed incident CKD-aP while on maintenance haemodialysis (2006-2021). Real-world IRH rates were applied to the time patients spent with resolved (mild/none) or persistent (moderate/severe) CKD-aP, based on randomised controlled trials of difelikefalin. Two-year national cost offsets of difelikefalin treatment were estimated using country-specific costs, the proportion of patients on haemodialysis, and established CKD-aP prevalence data for France, Italy, Portugal, Spain, Sweden, Switzerland, and the UK. Scenario analyses using alternative sources of CKD-aP prevalence and catheter infection rates were also conducted.
resultsOf 2329 patients free from CKD-aP at baseline, 17.6% developed CKD-aP during follow-up. IRH rates were 1.5-fold higher with incident CKD-aP versus those who remained CKD-aP free [incidence rate ratio 1.48 (95% confidence interval 1.19-1.83); P < 0.001]. Combining incidence rates with trial data, over 2 years, patients on difelikefalin were projected to have 61.7 weeks free of CKD-aP, versus 38.1 weeks with placebo. Estimated IRH-associated 2-year offsets through difelikefalin treatment were: €2-6.4 million in France, €1.2-3.5 million in Spain, €1.1-2.6 million in Italy, €1-3 million in the UK, €0.5-1.4 million in Portugal, €0.25-0.73 million in Switzerland, and €0.23-0.66 million in Sweden.
conclusionModelling difelikefalin's clinical benefits on real-world IRH-associated costs projected substantial potential cost offsets nationally, indicating how CKD-aP management may offer economic value in patients undergoing haemodialysis.
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