In early 2020, the U.S. Senate introduced important legislation that would extend Medicare coverage of immunosuppressive drugs for kidney transplant patients who do not have any other coverage.* This comes after the U.S. House of Representatives introduced its version of the bill in January of the same year.

Currently, transplant patients are covered for up to 36 months. Thanks to the passing of this legislation, entitled “Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020,” on December 22, 2020, coverage of immunosuppressive drugs will be indefinite as of January 2023.

Why is this bill important?

“When a patient receives a kidney transplant, the body knows that the new kidney is foreign; the body will attack the new kidney and try to damage or destroy it,” explains the National Kidney Foundation (NKF) in a press release. “Taking life-saving immunosuppressive drugs suppresses the body’s ability to do this and helps prevent organ rejection. Skipping even one dose will increase the chance of organ failure.”

In knowing that more almost one million Americans are impacted by end-stage renal disease (ESRD) leading to kidney transplantation, the legislation signed by Senator Bill Cassidy (R-LA) and Senator Richard Durbin (D-IL) represents a monumental move that will greatly help save patients’ lives, as well as taxpayers’ money. 

Lives and money saved

According to the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) report, the agency found that extending the coverage would result in savings of around $73 million over 10 years. The Office of the Actuary in the Centers for Medicare & Medicaid Services did a similar report and found there to be an even greater likelihood of savings—at $300 million over 10 years.

More importantly, patients would get the treatment they need without any lapses. The mother of a CKD patient, known as Bobbie, shared her story with the NKF and explained that without the extension of coverage, immunosuppressive medications were costing her upwards of $2,200 per month. For the average family, this is unaffordable. With Medicare coverage, the cost would be as low as $14 a month.

Bobbie’s son is one of many affected by chronic kidney disease (CKD). According to the NKF, “On behalf of 37 million Americans affected by kidney disease, we are grateful to Senators Cassidy and Durbin and Congressmen [Ron] Kind and [Michael] Burgess, who introduced similar legislation in the House late last year, for the strong bipartisan effort to extend Medicare coverage of immunosuppressive drugs and solve a problem that is years overdue.”   

For those interested, the official bill can be read in its entirety on the U.S. Congress’ website.

*National Kidney Foundation. (2021, Jan. 15). NKF Applauds Immunosuppressive Drug Coverage Legislation Passed in the U.S. Senate. https://www.kidney.org/news/national-kidney-foundation-applauds-landmark-immunosuppressive-drug-coverage-legislation-passed