Medicare Pays For Your Transplant But Not Anti-Rejection Drugs?

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According to the American Society of Transplantation (AST) “Organ transplant recipients expect to and must take immunosuppressive medications for the lifetime of their transplanted organ. Thus, organ transplantation should be viewed as a treatment rather than a cure. Similar to many chronic diseases, the need for medical therapy goes on indefinitely. If immunosuppressive medications are discontinued for any significant length of time, rejection of the transplanted organ is inevitable in all but a small minority of patients.”  http://www.a-s-t.org/index2.cfm?Section=public_policy&Sub1Section=key_position_statements&content=immunosuppressive_drug.cfm  (AST is an international organization of transplant professionals dedicated to advancing the field of transplantation through the promotion of research, education, advocacy, and organ donation to improve patient care www.a-s-t.org )

     

As I understand current law, Medicare will pay the cost of a transplant for eligible patients, they will even pay for a second transplant if necessary but they will only pay for expensive anti-rejection drugs for thirty six months.  There have been several attempts to change this situation but to date none have been successful.

 

In a special report on the issue of Medicare coverage of immunosuppressive drugs, AST also says,   

“Extended coverage of immunosuppressive medications makes good fiscal sense, as well. Patients who stop their immunosuppressive medications run the risk of rejection of the transplanted organ. This usually leads to a prolonged hospitalization, at a cost of several thousand dollars a day. Thus, the amount of money necessary to cover the cost of immunosuppressive medications could be spent in a matter of days for one hospitalization related to rejection. If a kidney transplant recipient’s kidney fails, a return to thrice weekly dialysis sessions is necessary, at an expense above and beyond the cost of immunosuppressive medications for the same time period. Loss of other transplanted organs ultimately leads to death or the need for another organ transplant, at a cost of hundreds of thousands of dollars.”  The AST Executive Committee approved this report on April 26, 2006.  They summarize their position in the following manner:

·         Extension of coverage for immunosuppressive medications for the lifetime of the transplanted organ

·         Access to insurance coverage for the lifetime of the transplanted organ

“AST supports initiatives that ensure the coverage of immunosuppressive medications for the lifetime of a transplanted organ, regardless of age and ability to pay. Ultimately, this will lead to improved transplant success rates and the greater ability of transplant recipients to return to a normal life.”

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Calling the current coverage policy “one of the great paradoxes in federal health policies,” US Representatives Dave Camp (R-MI) and Ron Kind (D-WI) introduced HR 3282 – the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2007 – despite their good intentions, however, the bill still has not passed congress. 

 

If the Medicare policy I have described is bothersome to you, then write to your members of congress, the U.S. Senate, The U.S. Department of Health and Human Services and President Obama.

 

Please comment in the space below or email your thoughts to  me at bob@baronson.org

 

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