Report: Medicare would save $400 million with transplant drug coverage
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A recent analysis by the Congressional Budget Office estimates Medicare could save $400 million in the course of 10 years if lifetime immunosuppressive drug coverage were offered to Medicare patients with a kidney transplant.
The analysis was requested by the U.S. House Committee on Energy and Commerce in support of H.R. 5534, the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020.
Congress member Michael Burgess, MD, R-TX, the ranking member of the subcommittee on health and the lead Republican co-sponsor of the bill, said previously the legislation “will improve patients’ adherence to immunosuppressive drugs and help to ensure that patients can maintain their transplants to hopefully avoid future kidney-related health care complications.”
The CBO estimates H.R. 5334 would increase spending by $10 million at the start of the program in 2023, “but in subsequent years, savings would accumulate as more enrollees avoid graft failures.
“In 2030, that effect would be a reduction in direct spending of $120 million. Over the 2021 [to] 2030 period, CBO estimates, H.R. 5534 would reduce direct spending by $400 million,” according to the analysis.
The savings would be aided by a premium Medicare would charge patients “equivalent to 35[%] of the actuarial value of the standard Part B benefit.” That would equate to $243 a month in 2023, when the program begins, the CBO said. The premium would increase gradually to about $345 in 2030.
“Using information on typical drug regimens for kidney transplant patients, CBO estimates that the annual cost of the drug benefit [to Medicare] would be about $3,100 per patient in 2023 and that it would rise to about $4,000 in 2030. That growth reflects CBO’s projections of growth in drug prices,” the agency wrote.
Care for Medicare beneficiaries with end-stage renal disease, the CBO estimates, would increase to an average of $117,000 by 2023 and increase to about $150,000 in 2030.
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