Immunosuppressive Drug Coverage Bill Gains Support

Extending lifetime immunosuppressive drug coverage for kidney transplant recipients is a top ASN legislative advocacy priority. On Capitol Hill, the efforts of ASN and other advocates have paved the way for Congress to again consider providing the much-needed lifetime coverage.

All patients with end stage renal disease are entitled to Medicare coverage for dialysis or kidney transplants. While Medicare pays for most kidney transplants, it only provides 36 months of immunosuppressive drug coverage for patients who do not qualify for Medicare due to age or disability. Patients who cannot afford immunosuppressive drugs lose the transplanted kidney and then require dialysis to stay alive. Immunosuppressive drugs cost Medicare $19,000 per year per patient; dialysis costs Medicare more than $77,000 per year per patient. This bill would provide Medicare coverage for immunosuppressive drugs only—protecting Medicare’s investment in the transplant—and all other Medicare coverage would cease after 36 months, as under current law.

On July 29, Sen. Richard Durbin (D-IL) introduced the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2011 (S. 1454). ASN worked behind the scenes with Rep. Michael Burgess, MD, (R-TX) and other members of the kidney advocacy community to recruit a bipartisan group of congressmen in the House to co-sponsor a companion bill to be introduced by Rep. Burgess. Supported by 18 cosponsors from both sides of the aisle, Rep. Burgess introduced the House companion bill (H.R. 2969) on September 21.

With both House and Senate bills now available for legislative consideration, ASN has redoubled its advocacy efforts in support of the Act. Public Policy Board Chair Thomas Hostetter, MD, Public Policy Board member Wolfgang Winkelmayer, MD, ScD, FASN, ASN President Joseph V. Bonventre, MD, PhD, FASN, and ASN Manager of Policy and Government Affairs Rachel Shaffer participated in a series of meetings with key Republican and Democratic leaders in the House and Senate to discuss the legislation this October. These meetings included discussions with Rep. Tom Marino (R-PA) and Rep. John Fleming, MD (R-LA), the Republican co-chair and vice-chair of the Congressional Kidney Caucus, a House caucus dedicated to educating Congress and the public about the problem kidney disease poses for our society. As a direct result of these discussions with ASN, Rep. Marino and Rep. Jim McDermott—the Democratic co-chair of the Congressional Kidney Caucus—stated that they would sign on as co-sponsors of the bill.

For the first time, ASN also incorporated social media into its advocacy efforts, posting updates about the bill’s introduction on Facebook and Twitter pages, and encouraging followers to send a message in support of the bill to their congressional representatives through ASN’s Legislative Advocacy Center (http://capwiz.com/ asn/issues/alert/?alertid=53775511). At press time, ASN members had sent more than 500 messages to Congress—an ASN record for member advocacy communications. If you haven’t sent in a message yet, please take a minute to do so today.

Broad support exists on both sides of the aisle for the bill, and ASN anticipates that many more members will support the bill in the coming weeks and months. So, a bill that would protect transplants and help more patients receive the gift of life—with broad bipartisan support—sounds like a slam dunk, right? Not so fast. As seen this summer with the debt ceiling debacle, nothing is certain on Capitol Hill at this time. Several potential impediments lurk, most importantly, the debt “super committee,” which is tasked with trimming the deficit by up to $1.5 trillion. There is a distinct possibility that the debt-reduction process could effectively paralyze Congress, preventing consideration and passage of smaller (though worthwhile) bills. Moreover, the Congressional Budget Office (CBO) most recently estimated the bill to cost $600 million over 10 years—although the actual cost is actually likely much lower, especially since the two most commonly used drugs have gone generic since CBO made that estimate. Getting new spending legislation passed is an uphill battle given the increased controversy around the nation’s debt issues.

Nonetheless, ASN is hopeful that its advocacy efforts, together with those of other members of the kidney and transplant communities, will come to fruition this year. The bill is generally recognized by both parties as a common-sense piece of legislation that would provide considerable benefit to society. Building upon this accord, lawmakers stand a legitimate chance of overcoming the current political climate to provide the lifetime drug coverage that patients need. You may view the joint ASN, ASPN, and RPA letter to the debt super committee at www.asn-online.org. To send a letter to your congressional representatives in support of the bill, please visit http://capwiz.com/asn/home/.


October-November 2011 (Vol. 3, Number 10 & 11)