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November 8, 2007
Washington, DC - U.S. Senators Dick Durbin (D-IL) and Thad Cochran (R-MS) introduced a bill in the Senate, The Comprehensive Immunosuppressive Drug Coverage for Transplant Patients Act, that would eliminate the three-year time limitation on Medicare coverage of anti-rejection medications for kidney transplant recipients who are not aged or not disabled.
Under the current Medicare End Stage Renal Disease (ESRD) program, kidney transplant recipients who are not Medicare-aged or Medicare-disabled are eligible for Medicare benefits only for the first 36 months following their transplants, including the coverage of the immunosuppressive drugs they must take daily for the rest of their lives. Following that time period, only patients 65 and older or disabled are eligible for continued benefits.
“Congress previously eliminated the time limitation for immunosuppressive coverage for aged and disabled Medicare beneficiaries, but a gap in coverage remains for kidney transplant recipients who are not Medicare aged or disabled,” said John Davis, CEO of the National Kidney Foundation. “Many of these kidney recipients face uncertainty in obtaining the drugs necessary to preserve their transplant, and today’s action by Senators Durbin and Cochran will alleviate a financial burden and barrier to organ transplantation for many kidney patients.”
“Medicare has made a huge difference in the lives of people like me who need a lot of expensive medicine after a kidney transplant,” said Jennifer Dudley, a 54-year old kidney transplant recipient and NKF member. “For many, it's the difference between choosing the medicine they need to live or food and shelter for their families. Once the coverage runs out, the choices become really difficult.”
The Medicare ESRD program pays for dialysis and transplantation for over 350,000 kidney disease patients. Dialysis services cost the program over $65,000 per-patient annually and the cost of immunosuppressive drugs ranges from $10,000 to $20,000 annually.
"If I can’t afford the expensive medication, I’d have to wait for my kidney to fail, then go back on dialysis which Medicare would cover and try to get another kidney. But that doesn’t make sense,” said Emily Biondi, a 24-year old kidney transplant recipient and NKF volunteer. “My father gave me one of his kidneys and I don't want it to go to waste. I am constantly worried about how I am going to get my medication. Luckily, as a college student, I am still under my parent’s health insurance. My next big worry is getting a job, but not just any job…a job with a health plan that will enable me to get my medication so I can live.”
According to the National Kidney Foundation, extending the coverage beyond the 36 month Medicare ESRD limit would improve transplant outcomes and enable more kidney patients with low-incomes to consider transplantation. Last summer, Rep. Dave Camp and Rep. Ron Kind introduced legislation to extend Medicare coverage for these drugs in the U.S. House of Representatives
The National Kidney Foundation (NKF) helps to shape public policy on behalf of kidney disease patients. Together with local Divisions and Affiliates across the U.S., the NKF works with Congress and federal agencies, as well as with state governments to further legislation and regulation that improve the care and quality of life of kidney disease patients. Public policy efforts are supported by thousands of NKF People Like Us, a nationwide grassroots advocacy network comprised of chronic kidney disease patients, transplant recipients, organ donors, family, friends and health professionals. To learn more, visit www.kidney.org.