Organ transplantation involves transfer of a healthy organ from a living or deceased body into another individual’s body. Demand for organ transplant immunosuppressant drugs is rising due to increase in the number of people registering for organ transplant worldwide. Each year 35,000 to 40,000 additional people register for organ transplantation procedure. Kidney is the most commonly transplanted organ globally.
Lifestyle factors leading to chronic diseases of heart and liver, higher health expenditure, rise in awareness of personal insurance, globalization, growing elderly population, and skilled expertise in performing the procedures have led to an increase in demand for organ transplants across the world. Donated organs are allocated to patients based on blood type compatibility, size match, and waiting list time. Organ transplant immunosuppressant drugs are required to be administered for the rest of the patient’s life after organ transplant to suppress his/her own immune reaction to transplants. Thus, usage of immunosuppressive drugs is of prime importance to suppress allograft rejection.
Medicare Part A (hospital Insurance) covers solid organ transplants of kidney, lung, heart, pancreas, intestine, and liver under certain conditions. Medicare Part B (medical insurance) encompasses doctor services for certain organ transplants. The coverage for organ transplant includes necessary lab tests and examination before surgery. It also covers immunosuppressant drugs under certain conditions, follow-up care, and organ procurement.
According to the U.S. Renal Data System, Medicare spends an average of US$ 107,000 per year per person for all costs associated with kidney transplant. Additionally, expenditure for Medicare related to immunosuppressive drugs is around US$ 17,000 per year. Medicare covers the cost of organ transplant immunosuppressant drugs for only three years or 36 months after transplantation. Patients have to pay for the medication after this period. This could cause transplant patients to cease or reduce medication if they find it unaffordable.
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