Medicare policy on antirejection drugs imperils kidney transplants

Kidney transplants can significantly improve the health of thousands of people in the United State with failing kidneys, but their success depends on taking immunosuppressive drugs, notes Matthew Cooper, MD, director of kidney and pancreas transplantation at Medstar Georgetown Transplant Institute and professor of surgery at Georgetown University S

Kidney transplants can significantly improve the health of thousands of people in the United State with failing kidneys, but their success depends on taking immunosuppressive drugs, notes Matthew Cooper, MD, director of kidney and pancreas transplantation at Medstar Georgetown Transplant Institute and professor of surgery at Georgetown University School of Medicine. However, Medicare covers these drugs for only 36 months for most people who receive new kidneys. Many patients find themselves back on dialysis and in need of a new kidney because they struggle to pay for the drugs when their Medicare coverage ends. A 2012 New England Journal of Medicine article reported that nearly 70% of kidney transplant programs reported either a death or transplant loss due to patients' inability to pay for their antirejection medications. In May 2019, HHS conducted an analysis that estimated significant cost savings from extending immunosuppressive coverage for kidney transplant patients by averting future dialysis and re-transplantation. CMS' Office of the Actuary concluded that extending coverage could save Medicare as much as $300 million over 10 years. In December 2019, Reps. Ron Kind (D-WI) and Michael Burgess (D-TX) introduced the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act (H.R. 5534) that proposes to extend Medicare coverage of immunosuppressive medications for kidney transplant recipients for life.