Congress must pass H.R. 5534 to extend immunosuppressive drug coverage
New York, NY - Jan. 8, 2020 – The National Kidney Foundation’s Board of Directors member Dr. Matthew Cooper will testify on Wednesday, January 8th before the U.S. House Energy and Commerce Health Subcommittee to support H.R. 5534, a bill which would make immunosuppressive drug coverage available to all kidney transplant patients and remove the 36-month limit for Medicare coverage currently in place.
The “Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act,” if signed into law, would provide critical access to drugs that work to prevent rejection of the donated organ by the patient’s immune system. Currently, Medicare only covers the cost of the important drug treatment for 36 months after a transplant unless the individual is Medicare-aged or Medicare-disabled. However, a patient must take immunosuppressive drugs for the life of the transplant or risk organ failure. If patients cannot afford the drugs after Medicare is exhausted and the organ fails, they must go on dialysis or be fortunate to receive another transplant to survive. Medicare covers lifetime dialysis for all patients who do not have other means to pay for the costly multi-weekly treatments and pays for a re-transplant.
“As a transplant surgeon for nearly 20 years, I have witnessed firsthand the impact of this shortsighted policy,” Dr. Cooper will testify. “Patients struggle to pay for the immunosuppressive drugs needed to maintain the health of their transplant when their Medicare coverage ends, especially lower income patients who lack group health insurance or do not qualify for Medicaid or other assistance. These financial pressures might force a patient into rationing their immunosuppressive drugs or forgoing them altogether, either of which almost absolutely results in graft failure.”
“Medicare coverage of immunosuppressive drugs for kidney transplant patients will not only save lives but save taxpayers money," said NKF CEO Kevin Longino, and kidney transplant recipient. "When patients cannot afford their medication, they often skip doses or are forced to make difficult choices between paying for basic necessities and paying for medicine they need to prevent organ failure. This legislation will put an end to that practice, an unintended consequence that is forcing patients into unimaginable circumstances."
Dr. Cooper of the Medstar Georgetown Transplant Institute, Washington, DC., will testify that dialysis costs Medicare about $86,000 per year per patient, while immunosuppressive drug treatment costs just $2,300 a year per patient. Each transplant can cost about $110,000, Cooper will testify. If Medicare would provide immunosuppressive drug treatment for life, an estimated $300 million will be saved in the first 10 years, Cooper reports.
“As a taxpayer, it is doubly frustrating that Medicare will pay for dialysis and for the first and second transplant but will not pay for the medications needed to maintain and preserve the first transplant,” Cooper will testify.
Cooper will tell the committee that H.R. 5534 will reduce graft loss, reduce demand for another transplant, enable more patients to seek a first transplant, and protect the taxpayers from inefficient and wasteful expense.
The National Kidney Foundation (NKF) worked closely with the bill’s sponsors on its introduction and calls on Congress to pass this life-saving legislation. NKF is America’s largest and oldest health organization dedicated to the awareness, prevention and treatment of kidney disease for the estimated 37 million adults with chronic kidney disease (CKD) and for tens of millions of people at risk of CKD. As an organization that has successfully advocated to improve coverage of immunosuppressive drugs for transplant recipients, NKF applauds the Committee for the hearing on H.R. 5534, and especially recognizes Representatives Ron Kind (D-WI) and Michael Burgess (R-TX) for introducing this bipartisan legislation and for their historic leadership on this important issue.
Dr. Cooper is a transplant surgeon serving as the Director of Kidney and Pancreas Transplantation at the Medstar Georgetown Transplant Institute. He is actively involved with many patient advisory boards and professional societies. In addition to the NKF’s Board of Directors, Cooper serves on the Foundation’s Transplant Task Force and Public Policy Committee. He most recently served as the Co-Chair of the NKF Consensus Conference to Decrease Kidney Discards.
Kidney Disease Facts
In the United States, 37 million adults are estimated to have chronic kidney disease—and most aren’t aware of it. 1 in 3 American adults are at risk for chronic kidney disease. Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity and family history. People of African American, Hispanic, Native American, Asian or Pacific Islander descent are at increased risk for developing the disease. African Americans are 3 times more likely than Whites, and Hispanics are nearly 1.5 times more likely than non-Hispanics to develop end-stage renal disease (kidney failure).
The National Kidney Foundation (NKF) is the largest, most comprehensive, and longstanding patient-centric organization dedicated to the awareness, prevention, and treatment of kidney disease in the U.S. For more information about NKF, visit www.kidney.org.