Some Kidney Transplant Drugs are Just Too High

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An estimated 20 million Americans suffer from chronic kidney disease, including 400,000 individuals who are undergoing treatment for end-stage renal disease (ESRD), or kidney failure. Most commonly caused by diabetes, high blood pressure or old-age, kidney failure is expected to claim more than 2 million lives by 2030. Without dialysis or a kidney transplant, patients suffering from kidney failure will not survive.

Since transplant organs are in short supply, most patients must undergo dialysis treatment, a process that substitutes for healthy kidneys by mechanically filtering body wastes and excess fluids from the bloodstream, three to four times per week.

When coupled with anti-rejection agents known as immunosuppressive drugs, kidney transplants are a safe, cost-effective procedure that can extend and significantly improve the lives of patients suffering from ESRD, allowing them the freedom to forgo time-consuming and costly dialysis treatments three to four times per week. However, the only Medicare beneficiaries eligible for lifetime coverage for immunosuppressive drugs are those individuals: (1) that are eligible because they are aged or disabled, and (2) those whose transplant was paid for by Medicare. Other ESRD patients have a limited benefit or no benefit at all, as described below:

ESRD Medicare Beneficiaries--Limited 36 Month Coverage - If an individual has Medicare coverage only because of kidney failure (ESRD), Medicare will pay for immunosuppressive drug therapy for only 36 months, leaving the patient to pay for expensive drugs out-of-pocket after that time period. If the patient cannot afford the drugs after the 36 month time period, the transplanted kidney will stop working and the patient will either return to more costly dialysis treatment, or will die.

To help ensure the long-term viability of kidney transplants and avoid costly dialysis treatments, Congress should enact legislation that would extend coverage for immunosuppressive drugs furnished to those who have received a kidney transplant under the Medicare program, and whose entitlement to coverage would otherwise expire.

If you agree with this initiative click here to tell your U.S. Representative and Senators: Vote for the "Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2013."


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