Antirejection Medications for Life

Kidney transplant recipients must take antirejection medications (immunosuppressants), which cost thousands of dollars per year. Currently, Medicare coverage for these drugs is limited to 36 months post-transplant. Many patients are unable to afford these medications and many reduce or stop taking these medications after 36 months, thus risking the rejection of their transplanted kidneys. Others, knowing they would not be able to afford these medications, choose not to pursue transplantation as a treatment option.

Last year�s Medicare Benefits Improvement and Protection Act (BIPA) provided permanent Medicare coverage of immunosuppressive drugs only for those who have a Medicare-funded transplant and have Medicare age or disability status. See this press release on last year's legislation from the National Kidney Foundation (NKF).

New legislation has been introduced that would extend Medicare coverage for immunosuppressive drugs for those not covered by last year's legislation. Medications would be covered at 80% under Part B after the $100 annual deductible is met. Here is a press release on this proposed legislation from the NKF.

Working together with the National Kidney Foundation, Senators Mike DeWine (R-OH) and Blanche Lincoln (D-AR) and Representatives Dave Camp (R-MI) and Karen Thurman (D-FL) have introduced this new bill entitled, "Immunosuppressive Drug Coverage Act of 2001". It has been assigned bill number S. 880 in the Senate and H.R. 1839 in the House. Here is the text of the bill.

Here is the Summary and Status Records of the House version and the Senate version from thomas.loc.gov.

Here are some of the benefits this legislation would bring:

* If immunosuppressive medication coverage is indefinite, those who have no other health insurance to pay for these expensive medications may for the first time have an opportunity to choose to seek a transplant.

* One major barrier to adherence -- cost -- will be removed, possibly extending organ survival and reducing long-term costs of care.

* This legislation would encourage more people on dialysis and especially those with transplants to work since many transplant recipients fear the loss of Medicare benefits for immunosuppressive medications more than loss of cash disability benefits.

* Because this bill requires group health plans to maintain the same level of coverage for immunosuppressive medications that they provided prior to this legislation, this provision effectively eliminates the argument that if Medicare covers medications, commercial health insurers will drop medication coverage.

When urging your senators and representative to become co-sponsors of this legislation, make sure to mention the appropriate bill numbers (S. 880 or H.R. 1839). Click here to locate your representative by zip code. Click here for a listing of senators by state.


[This message has been edited by Gary Peterson (edited 02-18-2003).]