Korsuva® (Difelikefalin) – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers Korsuva (difelikefalin) for adults with moderate-to-severe CKD-associated pruritus on hemodialysis and excludes pruritus from non-CKD causes, pruritus only during dialysis, palmar‑only pruritus, and use in peritoneal dialysis. Coverage requires FDA‑label dosing, nephrologist prescription/consultation, documented hemodialysis and diagnosis, prior failure/contraindication/intolerance to other pruritus therapies for medically necessary approval, initial and reauthorization periods ≤12 months, and documentation of clinical benefit for continuation.

"Documentation that pruritus is not limited to occurring only during the dialysis session and is not localized only to the palms."

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