title: Future of Medicare immunosuppressive drug coverage for kidney transplant recipients in the United States.
abstract: Kidney transplantation is the preferred treatment for patients with ESRD. It improves the quality of life in recipients, increases patient survival, and is also substantially less costly than maintenance dialysis. Long-term transplant success requires immunosuppressant drug therapy for the life of the allograft. Under current law, Medicare coverage for most recipients (except for those recipients over 65 years of age or with nonkidney-related disabilities) lasts only 3 years, leaving many recipients unable to afford these medications. Lack of drug therapy often leads to allograft rejection, resulting in premature graft failure, return to dialysis, or death. This article reviews the current policy for Medicare immunosuppressive drug coverage and analyzes the potential impact of pending legislative proposals H.R. 2969 and S. 1454 and the Patient Protection and Affordable Care Act.
authors.affiliation: Division of Nephrology, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA. bt2294@columbia.edu
authors.forename: Bekir
authors.initials: B
authors.lastname: Tanriover
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Stone
authors.forename: Sumit
authors.initials: S
authors.lastname: Mohan
authors.forename: David J
authors.initials: DJ
authors.lastname: Cohen
authors.forename: Robert S
authors.initials: RS
authors.lastname: Gaston
mesh_terms: D016527:Drug Costs; D005544:Forecasting; D006084:Graft Rejection / Q000191:economics / Q000276:immunology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects; D005102:Health Expenditures; D006297:Health Services Accessibility / Q000191:economics / Q000331:legislation & jurisprudence / Q000639:trends; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000191:economics / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000191:economics / Q000331:legislation & jurisprudence / Q000401:mortality / Q000639:trends; D006278:Medicare / Q000191:economics / Q000331:legislation & jurisprudence / Q000639:trends; D058991:Patient Protection and Affordable Care Act / Q000191:economics / Q000331:legislation & jurisprudence / Q000639:trends; D012959:Socioeconomic Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D007166:Immunosuppressive Agents
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