Transplant failures linked to drug costs
NEW YORK (Reuters Health) - After children and adolescents receive an organ transplant, more than 90 percent do well at the one-year mark. Thereafter, unfortunately, the rate of loss of the grafted organ increases, investigators report.
Dr. Mark A. Schnitzler, from the St. Louis University School of Medicine, and his associates believe that the transplant failure rate is often related to the inability to pay for immune suppressing drugs, which are required for the remainder of the patient's life to prevent rejection of the transplant.
These drugs "are incredibly expensive, sometimes more than $13,000 a year," Schnitzler comments in a university press release.
He and his associates have reviewed the financial aspects of continuing graft survival, and report their findings in the medical journal Pediatric Transplantation.
Medicare pays for most organ transplants in the U.S. However, coverage of immunosuppressant drugs ends 36 to 44 months after surgery or when the patient reaches adulthood. Many patients, especially young adults, cannot afford to pay for these drugs. Moreover, only about 30 percent of young adults have health insurance.
"Even for families with insurance, the co-payments can be a huge financial burden," Schnitzler adds.
For individuals who have employer-sponsored and private health insurance, coverage ends once a patient reaches a lifetime maximum amount stipulated by their policies.
As a result of these circumstances, many transplanted organs are rejected and patients' lives are shortened.
One study of 1000 people who received a donor kidney found that graft loss more than doubled when Medicare coverage ended. Once the transplanted kidney no longer works, the risk of death increases 9-fold.
The cost to society of failed organ transplants is also high. One study of kidney grafts found that "functioning transplants are 10 times less expensive than allowing them to fail during the year following failure."
Schnitzler and his colleagues conclude that new public policies requiring lifetime health care coverage for organ transplant recipients would be cost-effective, and would prolong patients' lives.
SOURCE: Pediatric Transplantation, March 2007.
