title: Cost-effectiveness of Medicare's coverage of immunosuppression medications for kidney transplant recipients.
abstract: Kidney transplantation is the preferred method of treating patients with end-stage renal disease. Transplantation improves the quality of life of the transplant recipient and also results in reduced treatment costs owing to the cost difference between dialysis and the post-transplant immunosuppression medications. Currently, the USA's Medicare program covers immunosuppression medications for 3 years post-transplant for nonelderly, nondisabled patients, and there is currently a proposal to extend this coverage from 3 years to a lifetime for all transplant recipients. Upon expiration of the current 3-year benefit, some patients are unable to afford to pay for the medication on their own, resulting in graft loss and a return to dialysis. This article reviews studies that documented the improvements in long-term transplant outcomes attributable to previous coverage extensions of immunosuppression medications, from both 1-3 years post-transplant for all transplant recipients in 1993 and the coverage extension from 3 years to lifetime for elderly and disabled patients in the year 2000. In addition, previous studies of the potential cost-effectiveness of a lifetime immunosuppression benefit for all patients are discussed.
authors.affiliation: Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, HLS II 560, Miami, FL 33199, USA. tpage@fiu.edu
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Page
authors.forename: Robert S
authors.initials: RS
authors.lastname: Woodward
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics* / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000191:economics* / Q000379:methods; D006278:Medicare / Q000191:economics*; D011788:Quality of Life; D006435:Renal Dialysis / Q000191:economics; D013997:Time Factors; D014481:United States
chemical_list: D007166:Immunosuppressive Agents