Congress extends Medicare coverage of immunosuppressive drugs for kidney transplant

Reviewed by Emily Henderson, B.Sc.Dec 23 2020

An estimated 375 adult kidney transplant recipients lose their transplant every year due to a lack of coverage of immunosuppressive medications after the prior 36-month Medicare coverage period.

Congress passes ASN priority legislation to extend immunosuppressive drug coverage for kidney transplant patients. The bipartisan bill is expected to save Medicare $400,000,000 over 10 years by averting the return of transplant patients to dialysis.

The US Senate passed the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act as part of a broad year-end legislative package, extending Medicare coverage of life-saving immunosuppressive medications for the life of the kidney transplant.

An estimated 375 adult kidney transplant recipients lose their transplant every year due to a lack of coverage of immunosuppressive medications after the prior 36-month Medicare coverage period. The policy change follows decades of advocacy by ASN members.

"This bipartisan, common-sense policy will directly improve the lives of hundreds of transplant patients and help increase the number of transplants available to patients," said Anupam Agarwal, MD, FASN, ASN President. "The bill's passage represents an enormous win for patients and the fulfillment of a top ASN priority. The society stands ready to work with policymakers to implement this legislation."

Kidney transplantation provides the best outcomes for most patients with kidney failure, however, a national organ shortage and misaligned incentives in the transplant system inhibit access to the therapy for many patients. The Comprehensive Immunosuppressive Drug Coverage Act removes a key financial barrier to receiving a transplant and improves stewardship of the limited supply of transplanted organs.

I and so many of my colleagues in the kidney and transplant community have been fighting for years to extend Medicare coverage of immunosuppressive drugs. Extending coverage of immunosuppressive medications will make transplant care more accessible and equitable. I commend Congress for taking action to address this important issue."

Barbara Murphy, MB BAO BCh, FRCPI, ASN Councilor, American Society of Nephrology

The legislation ensures that Medicare covers the cost of immunosuppressive drugs if no other coverage is available. A non-partisan Congressional Budget Office analysis estimated the legislation will save Medicare more than $400,000,000 over the course of 10 years by averting a return of transplant patients to hemodialysis.

"I am thrilled to see this critical legislation pass Congress. Kidney transplantation is the optimal therapy for most people with kidney failure, and a transplant is also the most cost-effective therapy for kidney failure," said Michelle Josephson, MD, FASN, ASN Policy, and Advocacy Committee Chair.

"I have cared for too many patients who have lost their kidney transplants because they could not afford their immunosuppressive medications after Medicare ceased coverage at 36 months, only to return to more-expensive dialysis."