Cost-Related Immunosuppressive Medication Nonadherence Among Kidney Transplant R

[okarol]

February 8, 2011
Cost-Related Immunosuppressive Medication Nonadherence Among Kidney Transplant Recipients


Evans RW, Applegate WH, Briscoe DM, Cohen DJ, Rorick CC, Murphy BT, Madsen JC.   Clin J Am Soc Nephrol.   2010 Dec;5(12):2323-8

The cost of immunosuppressive medications can be a barrier to medication adherence post-transplant. In this survey of transplant centers in the United States, most centers reported that they had patients who had difficulty paying for their immunosuppressive medications. The effects of this included graft losses and deaths. This has important implications for insurance coverage post-transplant, and suggests a relatively simple way to improve long-term transplant outcomes.

Abstract:
Immunosuppressive medications are essential in preventing kidney transplant rejection. Continuous insurance coverage for outpatient immunosuppressive medications remains a major issue. The objective of this study was to establish the prevalence and consequences of cost-related immunosuppressive medication nonadherence.

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Clin J Am Soc Nephrol 5: 2323–2328, 2010. doi: 10.2215/CJN.04220510

Roger W. Evans,* William H. Applegate,
†
David M. Briscoe,
‡
David J. Cohen,
§
Christopher C. Rorick,
†
Barbara T. Murphy,
i
and Joren C. Madsen
¶
*United Network for the Recruitment of Transplantation Professionals, Rochester, Minnesota;
†
Bryan Cave Strategies,
Washington, D.C.;
‡
Children’s Hospital Boston, Boston, Massachusetts;
Columbia University Medical Center, New York, New York;
Mount Sinai Medical Center, New York, New York; and
Massachusetts General Hospital, Boston, Massachusetts

Background and objectives: Immunosuppressive medications are essential in preventing kidney transplant rejection.
Continuous insurance coverage for outpatient immunosuppressive medications remains a major issue. The objective of this study was to establish the prevalence and consequences of cost-related immunosuppressive medication nonadherence.
Design, setting, participants, & measurements: A descriptive survey of all U.S. kidney transplant programs (n 5 254) was conducted. The response rate for the survey exceeded 99%. The main outcome measures included the following: transplant recipient concerns related to medication costs, ability to pay for medications, medication nonadherence and its consequences, and failure of transplant centers to place patients on the transplant waiting list.
Results: Continuous insurance coverage for outpatient immunosuppressive drugs is a problem having potentially grave consequences for the majority of kidney transplant recipients. More than 70% of kidney transplant programs report that their patients have an extremely or very serious problem paying for their medications. About 47% of the programs indicate that more than 40% of their patients are having difficulty paying for their immunosuppressive medications. In turn, 68% of the programs report deaths and graft losses attributable to cost-related immunosuppressive medication nonadherence. Some of the problems identified here are more significant for adult than pediatric patients.
Conclusions: The prevalence and consequences of cost-related immunosuppressive medication nonadherence among kidney transplant recipients have now been documented. The results presented here should serve as the necessary impetus for the development of health care policies supporting Medicare coverage of immunosuppressive medications for the life of the transplanted kidney.

http://www.nephrologynow.com/publications/cost-related-immunosuppressive-medication-nonadherence-among-kidney-transplant-recipients

[KarenInWA]

It's about time they do something about this.  Nothing cheapens the gift of organ donation more than not helping the recipient pay for needed meds to keep that organ functioning.  This goes for *all* kinds of organ donation!  It is reprehensible that this has been allowed to go on for as long as it has in this country.  In a country where "pre-exisiting conditions" is used as a barrier to receiving health insurance, yet we hold organ donation in a grand light and treat it as a miracle (which it is).  How does it make sense that we then treat those who have received organs as mere crap and tell them "Oh sorry, you're on your own!!!!"  Um, WTF???

KarenInWA

[paris]

A lot of my relatives thought you only take the anti rejection drugs while your body gets "use" to the new organ.  I don't think they believe me when I tell them what my co-pays add up to and that will be for life.  The public doesn't know ---  but most know how expensive chemotherapy is.  We need more attention to this.  I feel like my drugs are changing our way of living.  Drugs or fix the stove?  Drugs or a mini vacation?  Drugs or pay electric bill?   I am grateful for the drugs and will do anything to have my meds.   But, this really is a huge problem.