Feds Will Buy You a New Kidney. Then You're on Your Own

After 3-year cut-off, many kidney recipients have trouble affording necessary drugs
By Linda Hervieux,  Newser Staff
Posted Dec 26, 2016 12:28 PM CST
In this June 2016 file photo Dr. Matthew Cooper, left and Dr. Seyed Ghasemian transplant a donated kidney into a patient at MedStar Georgetown University Hospital in Washington.   (AP Photo/Molly Riley)
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(Newser) – How's this for a head-scratcher: The federal government will pay more than $100,000 for a kidney transplant but not for the expensive drugs needed to keep the organ in business after three years, NPR reports. Medicare will even pay for unlimited years of pricey dialysis necessary to keep people with kidney disease alive as they await a life-saving transplant. But for those fortunate enough to find a compatible donor, the specter of how to pay for anti-rejection drugs after the Medicare cut-off can be overwhelming. For Constance Creasey, 60, that means a looming monthly co-pay of $600 for the drugs she takes twice daily to keep her body from rejecting the kidney she received 18 months ago. "I have a year and a half to prepare, or save," she tells NPR. "How am I going to do this?"

To make matters worse, some insurance companies reclassified anti-rejection meds as "specialty drugs," eliminated a fixed co-pay and require patients to share the cost, which can quadruple the bill. Doctors say many in Creasey's position begin cutting back on their pills to conserve them, which can cause kidney failure again and force them back into dialysis, which costs Medicare $90,000 a year. Compare that to anti-rejection drugs, with an annual price tag of $15,000, and the advantages of drug coverage are clear. Although lawmakers are concerned about the $30 billion annual cost of kidney disease, so far the few interested in reform have been unsuccessful in getting Congress to act. "The Medicare [savings] in maintaining this drug coverage is better than putting people on dialysis," surgeon Matthew Cooper tells NPR. "To me this is a no-brainer." (Read more kidney disease stories.)

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