To: PKD Foundation - Gary Godsey, President and Chief Executive Officer, Ed Walter - National Kidney Foundation, NKF Chairman, President Donald Trump, The United States House of Representatives, and The United States Senate
Support the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act
Congress needs to support the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act (S. 1454 and H.R. 2969 ), which would end the 36 month limit of Medicare coverage for the required anti-rejection medications needed by kidney transplant recipients. If recipients are unable to afford their medications (after the 36 month limit) they will likely lose their "new" kidney and go on dialysis.
The annual estimated cost for the meds is approximately $24,000, compared to the annual estimated cost for dialysis of approximately $80,000. The New England Journal of Medicine reported a study that Medicare would realize a savings of $200 million a year if lifetime drugs were provided instead of dialysis! Where is common sense when it comes to the annual savings in those projections??
After 10+ years of this proposal stalling out in committee, lawmakers need to take action immediately to change this 36 month limit! It is not sound public policy or cost effective for Medicare to cover a kidney transplant and then stop immunosuppressive coverage after 36 months — which can, and all too often does, lead to someone rejecting/losing the transplanted kidney because they cannot afford their medicine. The hope is that recipients will have private insurance after the 36 months, but other studies indicate that 70% of the time this is not the reality.
Although Medicare will cover the meds for only a 36 month limit, they will pay for dialysis for lifetime!? The cost savings of removing the 36 month limit makes more sense than paying for a lifetime of dialysis without exception. Even if the recipient has private insurance, the proposal could include the rule that "other" insurance would be primary before Medicare would assist with the cost.
Please support this drive, share the information publicly, and let's get the word out that Congress needs to change this NOW!
The annual estimated cost for the meds is approximately $24,000, compared to the annual estimated cost for dialysis of approximately $80,000. The New England Journal of Medicine reported a study that Medicare would realize a savings of $200 million a year if lifetime drugs were provided instead of dialysis! Where is common sense when it comes to the annual savings in those projections??
After 10+ years of this proposal stalling out in committee, lawmakers need to take action immediately to change this 36 month limit! It is not sound public policy or cost effective for Medicare to cover a kidney transplant and then stop immunosuppressive coverage after 36 months — which can, and all too often does, lead to someone rejecting/losing the transplanted kidney because they cannot afford their medicine. The hope is that recipients will have private insurance after the 36 months, but other studies indicate that 70% of the time this is not the reality.
Although Medicare will cover the meds for only a 36 month limit, they will pay for dialysis for lifetime!? The cost savings of removing the 36 month limit makes more sense than paying for a lifetime of dialysis without exception. Even if the recipient has private insurance, the proposal could include the rule that "other" insurance would be primary before Medicare would assist with the cost.
Please support this drive, share the information publicly, and let's get the word out that Congress needs to change this NOW!
Why is this important?
I had a kidney transplant in 2012. The current Medicare coverage, for assisting with anti-rejection meds, is limited to 36 months after the transplant. People without private medical coverage will generally not be able to afford the meds ($1500-3000 per month) after the Medicare coverage ends in 36 months, and will lose their new kidney, end up on dialysis, and back on Medicare to cover the higher cost of dialysis.