It’s rare that I get to say this but, some good news came out of Washington today. The House Of Representatives passed the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act(H.R. 5534), which to summarize, will guarantee coverage for immunosupression drugs for the life of the transplanted organ. This will still need to pass through the Senate so while we haven’t crossed the finish line yet, this is a great first step.
For those unfamiliar with this legislation it may help to explain how the coverage of immunosuppression medication currently works. Today you can get a kidney transplant which is covered by medicare. Following that transplant you have to take immunosuppression drugs for the life of that kidney. If you don’t take them, your body will see your lifesaving organ as a foreign invader, attack it, and destroy it. Don’t get mad at your immune system – it’s simply doing what it’s been told. Taking immunosuppression drugs helps protect the organ by basically weakening your immune system just enough to keep it at bay. This of course introduces other potential problems as you might guess, but more on that some other day.
The good news is that medicare will cover those drugs from 3 years after the date of the transplant. The bad news is, medicare only covers them for 3 years. If you have adequate coverage on your own or through an employer you might be ok. But what if you don’t?
That’s right. You risk losing the kidney that medicare (a.k.a you and the rest American taxpayers) paid upwards of $35,000 for. On top of this you would either need to get another transplant or go on dialysis which is more than twice as expensive as a transplant.
You might be thinking that this sounds like a completely idiotic approach. You would be right.
Not only is it cruel towards patients, it’s fiscally irresponsible. By not providing coverage for the life of the organ the government not only doesn’t actually save money it spends an astronomically higher amount by having to keep these same patients on dialysis to keep them alive (while also depleting their quality of life). If they would just continue providing coverage for the medication, the amount paid out becomes much lower over the long run.
This bill is going to fill the gap so that medicare coverage will be there for the life of the organ. The domino effect here will be transplanted organs lasting longer, which will help decrease the number of people taking up a spot on the transplant list for what is a very finite number of available organs. For those who qualify, a transplant is the best form of treatment for somebody who has reached End Stage Renal Disease (ESRD). This is a long overdue step to address a shortcoming that shouldn’t have existed in the first place.
I would be curious to hear from those who have been impacted by the lack of extended coverage in the past. Leave a note in the comments below if you’ve had experience with this.
See the link below for the announcement on this legislation from the National Kidney Foundation: