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.

Keywords::

• cost–effectiveness
• immunosuppression medication
• kidney transplantation
• Medicare
• public policy

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Notes

QALY: Quality-adjusted life-year; USRDS: US Renal Data System.