On February 27, Senators Bill Cassidy, M.D. (R-LA) and Dick Durbin (D-IL) introduced legislation to extend Medicare coverage of immunosuppressive drugs for kidney transplant patients.  A top priority for ASN, the common-sense legislation would extend Medicare coverage of immunosuppressive medications for kidney transplant patients beyond the current 36-month limitation, ensuring that kidney transplant patients do not face losing their transplant due to an inability to afford their medications. “Our bill ensures that kidney transplant patients can afford the medication they need to survive and won’t have to skip or ration doses,” said Durbin. “Extending this coverage under Medicare is bipartisan and commonsense, and I urge my Senate colleagues to support this legislation.”

U.S. Senators Joni Ernst (R-IA), Jeanne Shaheen (D-NH), Sheldon Whitehouse (D-RI), and Todd Young (R-IN) joined as original cosponsors of the legislation, “Kidney transplants can give seniors suffering from serious kidney disease a new lease on life, but the medication they need to help ensure the surgery is successful is too often out of reach due to high costs,” said Shaheen. “This important legislation will help make sure Medicare patients are able to access these lifesaving drugs, avoid financial burden and focus on their recovery.”

More than 750,000 Americans have irreversible kidney failure, or end-stage renal disease, and need dialysis or a kidney transplant to survive, according to the United States Renal Data System. Each year, Medicare spends approximately $89,000 per dialysis patient and less than half, $35,000, for a transplant patient.

When a kidney failure patient receives a kidney transplant, they must take immunosuppressive medications to prevent the rejection and loss of the transplanted organ.  Currently, Medicare covers the cost of these critical medications for only 36 months, leaving many individuals who cannot afford other coverage at risk of rationing their medication and facing loss of the transplanted kidney. These patients would then face a return to dialysis, a more expensive therapy paid for by Medicare.

In 2019, the Department of Health and Human Services highlighted in two independent reports that extending coverage of immunosuppressive medications would save the Medicare program as much as $300,000,000 over the course of 10 years by preventing returns dialysis due to inability to afford medications. Extending coverage of immunosuppressive medications for kidney transplant patients is supported by the Administration, as highlighted by Secretary Azar during the signing of the Executive Order on Advancing American Kidney Health.

The Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act (S 3353), which would help save lives and reduce dialysis expenses, follows similar legislation introduced in the House in December by Representative Ron Kind and Representative Michael Burgess. That legislation would allow Medicare to pay for immunosuppressive drugs for kidney transplant patients for the lifetime of the organ transplant.

“Kidney transplantation is the optimal therapy for most people with kidney failure, and a transplant is also the most cost-effective therapy for kidney failure,” remarked transplant nephrologist and ASN Policy and Advocacy Committee Chair Michelle Josephson, MD, FASN, following a January hearing in the House on the legislation. “I have cared for too many patients who have lost their kidney transplants because they could not afford their immunosuppressive medications after Medicare ceased coverage at 36 months, only to return to more-expensive dialysis.”

The American Society of Nephrology will continue to support extending immunosuppressive coverage through numerous initiatives, including calling on lawmakers to pass the legislation during meetings with legislators at the upcoming Kidney Health Advocacy Day on April 1.