Assessing the Costs and Benefits of Extending Coverage of Immunosuppressive Drugs under Medicare

By statute, the majority of patients with end-stage renal disease (ESRD) are eligible for Medicare, regardless of age. Kidney transplantation is ultimately considered the best treatment for ESRD, but ESRD-related eligibility for Medicare coverage extends for only 36 months post-transplant. Given the costs to Medicare associated with patients who stop taking immunosuppressive drugs due to cost and revert to developing ESRD, requiring subsequent dialysis and/or kidney transplantation, ASPE analyzed the financial implications of extending Medicare coverage of only immunosuppressive drugs for the lifetime of the patient. We estimate that extending Medicare coverage of immunosuppressive drugs beyond three years post-transplant would result in ten-year accumulated savings of approximately $73 million.