Congress Passes Expansion of Immunosuppressive Drug Coverage for Transplants

[plugger]

This looks like HUGE news!!!!!!!!!!!!!!!

"Highlights

    An estimated 375 adult kidney transplant recipients lose their transplant every year due to a lack of coverage of immunosuppressive medications after the prior 36-month Medicare coverage period.
    Congress passes ASN priority legislation to extend immunosuppressive drug coverage for kidney transplant patients.
    The bipartisan bill is expected to save Medicare $400,000,000 over 10 years by averting the return of transplant patients to dialysis.

Washington, DC (December 22, 2020) — The US Senate passed the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act as part of a broad year-end legislative package, extending Medicare coverage of life saving immunosuppressive medications for the life of the kidney transplant. An estimated 375 adult kidney transplant recipients lose their transplant every year due to a lack of coverage of immunosuppressive medications after the prior 36-month Medicare coverage period. The policy change follows decades of advocacy by ASN members.

“This bipartisan, common-sense policy will directly improve the lives of hundreds of transplant patients and help increase the number of transplants available to patients,” said Anupam Agarwal, MD, FASN, ASN President. “The bill’s passage represents an enormous win for patients and the fulfilment of a top ASN priority. The society stands ready to work with policy makers to implement this legislation.”

Kidney transplantation provides the best outcomes for most patients with kidney failure, however a national organ shortage and misaligned incentives in the transplant system inhibit access to the therapy for many patients. The Comprehensive Immunosuppressive Drug Coverage Act removes a key financial barrier to receiving a transplant and improves stewardship of the limited supply of transplanted organs.

“I and so many of my colleagues in the kidney and transplant community have been fighting for years to extend Medicare coverage of immunosuppressive drugs” said Barbara Murphy, MB BAO BCh, FRCPI, ASN Councilor. “Extending coverage of immunosuppressive medications will make transplant care more accessible and equitable. I commend Congress for taking action to address this important issue.”

The legislation ensures that Medicare covers the cost of immunosuppressive drugs if no other coverage is available. A non-partisan Congressional Budget Office analysis estimated the legislation will save Medicare more than $400,000,000 over the course of 10 years by averting a return of transplant patients to hemodialysis.

“I am thrilled to see this critical legislation pass Congress. Kidney transplantation is the optimal therapy for most people with kidney failure, and a transplant is also the most cost-effective therapy for kidney failure” said Michelle Josephson, MD, FASN, ASN Policy and Advocacy Committee Chair. “I have cared for too many patients who have lost their kidney transplants because they could not afford their immunosuppressive medications after Medicare ceased coverage at 36 months, only to return to more-expensive dialysis.”

Senate passage of the legislation follows a Tuesday, December 8 approval of the bill in the US House of Representatives. The legislation is expected to be signed into law and will take effect in 2023.

Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has more than 20,000 members representing 131 countries. For more information, please visit www.asn-online.org or contact the society at 202-640-4660."

https://www.newswise.com/articles/congress-passes-expansion-of-immunosuppressive-drug-coverage-for-kidney-transplant-patients

[MooseMom]

2023?  Well, it's certainly a step in the right direction!

[iolaire]

Yes good news.

[plugger]

It is still a ways out, which makes it not quite as HUGE.  But I was wondering if I would ever see the day something like this would pass.  I am wondering why they have to wait though.

[PrimeTimer]

I'd say this is a step in the right direction. I never understood why coverage for the anti-rejection meds didn't cover the life of the transplant.

[MooseMom]

I'd say this is a step in the right direction. I never understood why coverage for the anti-rejection meds didn't cover the life of the transplant.

As I understand it, I think the original thinking was that transplantation would allow the return to work, so the employer's insurance package would pick up the cost.  I could be wrong, though.

[Hereware]

It's about time that we have good news. The new year is up ahead.

[plugger]

As I understand it, I think the original thinking was that transplantation would allow the return to work, so the employer's insurance package would pick up the cost.  I could be wrong, though.

We had a problem with that thought back in the day.  I got laid off while my daughter was under my insurance coverage for her transplant care.  We felt the need to drop the COBRA health insurance coverage on everybody in the family except my daughter - we didn't know how long it was going to be before I found another job.  I'll just say my wife was dealing with medical problems of her own, but being a Mom she was insisting I drop her coverage.  She insisted she could pay out-of-pocket and get by.  To this day it is a decision I hated making, but we rolled the dice and gratefully won.  I don't like thinking about what could have happened if we had lost that bet on my wife's health.