Health: Kidney recipients face lifelong expenses for medication

[okarol]

 Anti-rejection drug prices cost Oklahoma patients
Health: Kidney recipients face lifelong expenses for medication

BY SUSAN SIMPSON   
Published: October 26, 2009

Some of the 1,300 Oklahomans who have gotten kidney transplants fear they’ll die without anti-rejection drugs.

For most adult kidney recipients under age 65, Medicare pays for 80 percent of the cost of immunosuppressive drugs for three years after transplant. But the drugs are needed for a lifetime, and many patients say they can’t afford the medications on their own.

"It doesn’t make sense to pay for a transplant and then not pay for the medicine that keeps you from rejecting the organ."
Dr. David Nelson
Nazih Zuhdi Transplant Institute

Without the medications, they risk the transplanted kidney failing and the need for dialysis or another transplant.

Both options are more costly in the long run, said Dr. David Nelson of the Nazih Zuhdi Transplant Institute at Integris Baptist Medical Center.

"It doesn’t make sense to pay for a transplant and then not pay for the medicine that keeps you from rejecting the organ,” Nelson said.

Costly alternatives
Nelson and other members of the American Society of Transplantation lobbied Congress to extend coverage.

Although some in Washington are worried about the cost of extending benefits, Nelson said it costs more not to do so.

Nelson said it costs Medicare $17,000 a year to care for a post-transplant patient on anti-rejection drugs. But a year of dialysis for one patient costs the agency $71,000 and a transplant costs $106,000.

About 97 percent of kidney patients are covered by Medicare, Nelson said. Chronic kidney failure, also known as end-stage renal disease, is the only condition for which Medicare extends coverage for everyone, and not just those who already qualify because of age or disability — those groups have unlimited drug coverage.

The issue also affects patients who need to get kidney transplants.

A survey of U.S. transplant centers found that some patients were not placed on waiting lists because of concerns about how they’d pay for immunosuppressive drugs.

These drugs can cost patients up to $3,000 each month.

Integris pharmacists work closely with organ recipients to help them find new sources of coverage when Medicare assistance ends. Some patients are able to get free or discounted medications from manufacturers, said outpatient pharmacy director Marsha Conner.

Others find they simply must bear more out-of-pocket costs.

‘It’ll be a struggle’
Bob Scully got a kidney transplant three years ago. His Medicare drug coverage ends this month.

Scully, 55, also has insurance through BlueCross and BlueShield, which will pay half of his $1,200 a month drug bill.

"It’ll be a struggle, a little bit,” Scully said. "But it’s a matter of life or death if you don’t take care of your kidney.”

Scully got his kidney from his brother, a retired U.S. Army colonel.

Keeping transplanted organs healthy is an obligation to those who donated them, Nelson said.

But it’s a tragedy if the organs are lost because recipients can’t pay for their anti-rejection drugs because Medicare coverage expires, he said.

"It’s a disservice to the donor family or the living donor. It’s disrespectful to them that this state of affairs exists.”

Read more: http://www.newsok.com/anti-rejection-drug-prices-cost-oklahoma-patients/article/3412081#ixzz0V4A6BMUS