A recent New York Times article tells of a heart-wrenching story of a woman, named Margaret Oliver, who received a lifesaving kidney transplant. The government covered the costs under a special Medicare program for the hundreds of thousands of Americans with kidney failure; the only condition for which Medicare extends coverage to everyone.
Three years later, Medicare stopped paying for the expensive immunosuppressive drugs that Ms. Oliver needed to minimize the risk that her body would reject the organ. This was because the program covers 80 percent of the cost of immunosuppressive drugs, but only for 36 months after the transplant.
This week two senators introduced legislation that would require Medicare to cover the drugs for the life of the transplanted kidney. This legislation is not only beneficial for a transplant recipient's health status; it also provides a significant pharmacoeconomic benefit.
Transplantation generally provides better long-term outcomes and a higher quality-of-life than dialysis; however, patients then need to take immunosuppressive drugs for as long as they have the transplanted kidney. While many organ recipients are able to obtain health insurance through employers or spouses, others, like Ms. Oliver, find themselves with few options in the private insurance marketplace. If they lose the kidney, they have to return to dialysis and return to the organ waiting list. This may be the case with Ms. Oliver because the many months of interrupted treatment significantly weakened her new kidney and increased the chances that she will lose it in the near future.
Now that just doesn't sit right with me. If the immunosuppressive drugs are only covered for three years, then we might as well give in and offer transplants to known alcoholics; there is the same post-transplant liver failure possibility in both instances….so why the heck not?
Okay, well let's say that the government just isn't quite getting the health benefit. So let's put it in terms the government will understand; money.
While a transplant costs more than $100,000, the annual expenses for drugs versus dialysis speak for themselves. Medicare spends, on average, $17,000 a year for the immunosuppressive drugs for a kidney transplant recipient, compared to about $70,000 for a year of dialysis. As far as pharmacoeconomics go, the monetary benefit of extending
immunosuppressive drug coverage should be sufficient rationale for the government to pass the senators' legislation. I mean, isn't money all the government is worried about anyway?
BW706: Blog #8
Lisa Menard
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Yes, government is only concerned about money - keeping it and increasing it. As long as the problem does not pertain to them or their well being (they probably won't be too concerned if it's their mother, siblings, wife or children suffering), then they don't want to be bothered. It seems that requiring the drugs be covered for the life of the transplanted organ will improve quality of life and be better for the bottom line. Why wouldn't this legislation be approved, other than government deeming it a waste of time and money? Does this not follow under the role of taking care of your neighbor and improving their quality of life? Wouldn't they consider this both ethically and monetarily sound? Of course, it is to me, but if I was to think like congress, the answer is no.
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