• Timothy F Page and Robert S Woodward.
• Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, HLS II 560, Miami, FL 33199, USA. tpage@fiu.edu
• Expert Rev Pharmacoecon Outcomes Res. 2009 Oct 1; 9 (5): 435-44.

AbstractKidney transplantation is the preferred method of treating patients with end-stage renal disease. Transplantation improves the quality of life of the transplant recipient and also results in reduced treatment costs owing to the cost difference between dialysis and the post-transplant immunosuppression medications. Currently, the USA's Medicare program covers immunosuppression medications for 3 years post-transplant for nonelderly, nondisabled patients, and there is currently a proposal to extend this coverage from 3 years to a lifetime for all transplant recipients. Upon expiration of the current 3-year benefit, some patients are unable to afford to pay for the medication on their own, resulting in graft loss and a return to dialysis. This article reviews studies that documented the improvements in long-term transplant outcomes attributable to previous coverage extensions of immunosuppression medications, from both 1-3 years post-transplant for all transplant recipients in 1993 and the coverage extension from 3 years to lifetime for elderly and disabled patients in the year 2000. In addition, previous studies of the potential cost-effectiveness of a lifetime immunosuppression benefit for all patients are discussed.

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