title: The financial impact of immunosuppressant expenses on new kidney transplant recipients.
abstract: BACKGROUND
  This study aimed to examine kidney transplant recipients' ability to afford transplant-related out-of-pocket expenses and the financial impact of these expenses on their lives.
  
  
  METHODS
  This cross-sectional study involved 77 kidney recipients. Variables analyzed were: ability to afford daily necessities; impact of immunosuppressant expenses on patients' lives; awareness of Medicare support terminating three yr post-transplant; and strategies used to pay for out-of-pocket transplant expenses. The Economic Strain Scale measured financial strain.
  
  
  RESULTS
  Twenty-nine percent of kidney recipients experienced financial strain. Poor, less educated, and younger patients were more likely to report financial strain. Out-of-pocket expenses relating to kidney transplantation adversely affected patients' ability to afford leisure activities (35%), a house (27%), and a car (26%). Thirty-one percent reported that immunosuppressant expenses have had somewhat to great (adverse) impact on their lives. Of those on Medicare and not disabled (n = 41), 51% were unaware Medicare coverage will terminate and 71% did not know how long coverage lasts.
  
  
  CONCLUSIONS
  Financial strain presents a considerable risk to kidney recipients' ability to purchase immunosuppression. Socioeconomic disparities in recipients' financial strain may be a source of disparities in graft survival. Transplant professionals should better inform transplant candidates about financial consequences of transplantation.
authors.affiliation: Alden March Bioethics Institute, Albany Medical Center, Albany, NY 12208, USA. gordone1@mail.amc.edu
authors.forename: Elisa J
authors.initials: EJ
authors.lastname: Gordon
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Prohaska
authors.forename: Ashwini R
authors.initials: AR
authors.lastname: Sehgal
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D005382:Financing, Personal; D006085:Graft Survival; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics*; D016030:Kidney Transplantation / Q000191:economics*; D008297:Male; D006278:Medicare / Q000191:economics; D008875:Middle Aged; D014481:United States
chemical_list: D007166:Immunosuppressive Agents