Penny Wise, Pound Foolish? Medicare Coverage Limits after Kidney Transplantation

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eHombre

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According to current law, Medicare pays for the dialysis treatment of patients with end-stage renal disease, for kidney transplantations in eligible recipients, and for 3 years of immunosuppressive therapy post-transplantation (or lifetime coverage if 65+ or disabled). Lifetime immunosuppressive therapy is necessary to maintain a functioning transplanted kidney, but the high cost of treatment leads to nonadherence and transplant failure. Patient outcomes are significantly worse in these cases, as is the overall cost to Medicare. Please write your congressional representative and ask him or her to support H.R. 2969.

$75,000 - Annual cost to Medicare of dialysis treatment
$110,000 - Initial cost to Medicare of kidney transplantation
$15,000 - Annual cost of immunosuppressive therapy


http://www.nejm.org/doi/full/10.1056/NEJMp1114394

"The potential for cost savings through lifetime drug coverage is supported by empirical data. . . . Unsurprisingly, economic analyses also confirm that providing lifetime funding for immunosuppressive medications would lower overall costs — saving an estimated $200 million annually — with the greatest impact seen among patients least able to pay.
. . .
[A proposed amendment to the Social Security Act, H.R. 2969, is before Congress and would grant lifelong coverage beyond the current 3 year coverage for immunosuppressive medications to all kidney-transplant recipients in the United States.] H.R. 2969 represents a key opportunity to correct an irrational, needlessly wasteful policy that has harmed many U.S. patients. Its passage would achieve three important objectives: protect Medicare's investment in each renal allograft, help bring U.S. kidney-transplant outcomes up to par with those in other developed countries, and most important, save the lives of people with kidney failure."

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That's all fine and dandy, but where do they propose that we obtain all of these extra kidneys for transplant?

Sorry if the post was misleading. This article is weighing treatment options for patients post-transplantation and looking at Medicare coverage for immunosuppressive regimens specifically. It's not advocating that we replace hemodialysis with transplantation, since of course spare kidneys are a finite resource.
 
Members don't see this ad :)
Sorry if the post was misleading. This article is weighing treatment options for patients post-transplantation and looking at Medicare coverage for immunosuppressive regimens specifically. It's not advocating that we replace hemodialysis with transplantation, since of course spare kidneys are a finite resource.

Oh, that makes much more sense. :)
 
I can only imagine the level of administration and resources dedicated to sifting through all these patients and determining eligibility or exclusion based on the tiniest minutiae. Really, there is so much money in the system, and it is so poorly spent.
 
I can only imagine the level of administration and resources dedicated to sifting through all these patients and determining eligibility or exclusion based on the tiniest minutiae. Really, there is so much money in the system, and it is so poorly spent.

Author affiliations from the article:
From the Division of Nephrology, University of British Columbia, Vancouver (J.S.G.); the Division of Nephrology, University of Alberta, Edmonton (M.T.); and the Interdisciplinary Chronic Disease Collaboration, Calgary, AB (J.S.G., M.T.) — all in Canada.


Canadian doctors tsk-tsking us into reasonable health policies. I can get behind that. :D
 
That's all fine and dandy, but where do they propose that we obtain all of these extra kidneys for transplant?

[youtube]http://www.youtube.com/watch?v=D_5nLxZVoPo[/youtube]
 
Author affiliations from the article:
From the Division of Nephrology, University of British Columbia, Vancouver (J.S.G.); the Division of Nephrology, University of Alberta, Edmonton (M.T.); and the Interdisciplinary Chronic Disease Collaboration, Calgary, AB (J.S.G., M.T.) — all in Canada.


Canadian doctors tsk-tsking us into reasonable health policies. I can get behind that. :D

Of course; our third favourite national pastime, after hockey and ice-fishing, is jumping on a high horse and preaching all things socialized medicine, or didn't you know? ;)
 
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