CHRONIC TONIC posts on Thursdays at 7 EST, it is a place to share stories, advice, and information and to connect with others with chronic health conditions and those who care for them. Our diarists will report on research, alternative treatments, clinical trials, and health insurance issues through personal stories. You are invited to share in comments (and note if you'd like to be a future diarist). In addition to our weekly diaries, please join us for ongoing conversations at the Kossacks Networking site.
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Chronic Tonic: Take Action to Extend Medicare Coverage of Immunosuppressive Drugs for Transplants 6/25/09
Today’s Diary By: MsGrin
Be sure to visit the Thursday Health Care Series - Kitsap River (our diarist last week) has written a beautiful piece called This Will Make You Weep
Immunosuppressive drug access through Medicare is an issue which has been of great concern to me as I've watched friends get transplants. This is craziness.
I got an email yesterday asking for help to get the Medicare laws changed so that people with transplants can have the drugs they will continue to need:
Organ transplant recipients must take immunosuppressive drugs for the life of the transplant to help prevent the body from rejecting the organ. HR 1458 would extend immunosuppressive drug coverage for Medicare-eligible kidney transplant recipients for the life of the transplant. They would not have access to other parts of Medicare, but this would ensure that they could retain Part B access to these expensive drugs. Currently, Medicare pays for most kidney transplants but covers drugs for only 36 months post-transplant as part of the Medicare ESRD benefit.
Here's how to take action:
Ask the House to Support Immunosuppressive Drug Extension in Health Care Reform Legislation
I am calling on you to co-sponsor HR 1458. This legislation will extend Medicare immunosuppressive drug coverage for kidney transplant recipients for the life of the transplant if the patient does not qualify for Medicare because of age or disability, or if the patient does not have group health insurance with this benefit, as long as the recipient had Medicare eligibility at the time of transplant.
This legislation was included in the House health care reform discussion draft, and we need your support to ensure it remains in the final bill that becomes law.
Organ transplant recipients must take immunosuppressive drugs for the life of the transplant to prevent the organ’s rejection by the body. Currently, Medicare’s ESRD program pays for most kidney transplants but covers these drugs for only 36 months after the transplant. At the end of this time, the transplant recipient must pay for immunosuppressive drugs through private insurance, public or pharmaceutical programs or pay out-of-pocket.
Immunosuppressive drugs are expensive, but the alternative is even more costly. Medicare spends an average of $17,000 annually for kidney transplant patients. If the kidney transplant fails, the person returns to dialysis at which point, Medicare spends an average of $71,000 per year on a dialysis patient.
Under this legislation, a kidney transplant recipient would have access to these drugs under Medicare Part B by paying the premium, if he or she does not have group health insurance with this benefit.
After Medicare makes the investment in a kidney transplant, we should do all that we can to preserve it. Too often, transplant patients must choose between taking the medication they need or other living expenses, and when they reduce or stop medication, it causes the transplant to fail. Some dialysis patients do not even consider a transplant because they know they will not be able to pay for the drugs at the end of the 36 months.
Please cosponsor HR 1458 today. It is good stewardship, and good health policy.
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