New analysis shows extending coverage of immunosuppressive drugs would result in Medicare savings

According to a new analysis from the U.S. Department of Health and Human Services (HHS), extending Medicare immunosuppressive drug coverage for kidney transplant recipients for more than three years post-transplant would result in Medicare savings of $73.4 million over 10 years. The American Kidney Fund (AKF) has long-supported policy proposals to provide lifetime immunosuppressive drug coverage for non-disabled kidney transplant patients under the age of 65. Doing so would lead to better health outcomes for patients because fewer would revert to dialysis, and this HHS analysis demonstrates substantial cost savings to Medicare would also result.

Immunosuppressive drugs prevent transplanted organs from being rejected, and transplant recipients need to take those drugs for the life of their transplant. For kidney transplant recipients under the age of 65 who have Medicare solely based on end-stage renal disease (ESRD), their Medicare coverage, including Medicare Part B coverage for immunosuppressive drugs, ends 36 months after their transplant. Patients that are unable to obtain or afford other insurance or pay for immunosuppressive drugs out of pocket face significant challenges in adhering to their medication regimen, which can lead to the loss of their transplanted kidney and a return to dialysis.

The Office of the Assistant Secretary for Planning and Evaluation (ASPE) at HHS analyzed the costs and savings of extending Medicare coverage only for immunosuppressive drugs beyond 36 months (i.e., the analysis did not consider extending full Medicare coverage). ASPE/HHS found that the cost to the federal government of providing extended immunosuppressive drug coverage would grow at a slower rate than the savings that would result from averting cases of patients going back to Medicare-covered dialysis treatment. Looking at a 10-year implementation window beginning in 2020, savings would result starting in the fifth year and would continue to increase each subsequent year, leading to an accumulated 10-year savings of approximately $73.4 million.

AKF is hopeful that this new analysis will spur renewed discussion among policymakers to extend Medicare immunosuppressive drug coverage for all kidney transplant recipients.

Posted: | Author: AKF Staff

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