Healio Special Report: Health Care and Politics
Healio Special Report: Health Care and Politics
January 07, 2020
2 min read

House bill would cover lifetime anti-rejection drugs for kidney transplants

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Two members of the U.S. House of Representatives have introduced legislation that would extend lifetime coverage of anti-rejection drugs for patients with a kidney transplant, regardless of age.

Currently, only patients 65 years old and older receive lifetime Medicare coverage for anti-rejection drugs when they have a kidney transplant. Patients who are younger than 65 years old have similar Medicare drug coverage post-transplant, but only for 3 years before the coverage expires.

The Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2019 was introduced by Reps. Ron Kind, D-Wis., and Michael Burgess, R-Texas. The bill, H.R. 5534, has been referred to the House Energy & Commerce Committee, of which Burgess is a member.

The legislation, if signed into law, would become effective Jan. 1, 2022.

In a statement, the National Kidney Foundation said the legislation “will not only save lives but save taxpayers money. 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.”

American Society of Transplantation President Emily Blumberg said in a press release, “Once passed, this important patient-focused legislation will eliminate the current arbitrary 36-month Medicare coverage limit for immunosuppressive medications for transplant recipients who, without these critical drugs, may lose their transplanted organs.”

Two government-led reports on the cost of extending immunosuppressive drug coverage to kidney transplant patients show there would be significant savings. In May 2019, the Office of the Assistant Secretary for Planning and Evaluation of the HHS said extending the coverage would result in an accumulated savings of approximately $73 million in 10 years.

“This analysis finds that extending Medicare coverage of immunosuppressive drugs beyond 3 years post-transplant would result in savings to Medicare starting in the fifth year,” according to the report.

A second report from the CMS Office of the Actuary, released on May 23, 2019, showed a savings of $300 million in 10 years.