MEDICATION ASSISTANCE PROGRAMAOTA has recognized the need to assist transplant patients with the cost of their immunosuppressant drug therapy. We offer prescription assistance at no charge. Simply click on the link www.aotarx.com and enroll for free and download your free prescription card.
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In addition, ConsumerAffairs.com Online Pharmacy provides reviews, brand comparisons, and features on various online pharmacies. Once your enrollment is active, you can use the on-line Rx Pricing tool to determine your medication price at any of nearly 33,000 participating retail pharmacies nationally. At the time of purchase, simply present your identification card and your prescription to your pharmacist and ask that all future prescriptions be filled utilizing the program.
Although dramatic improvements have occurred in organ transplantation, all patients must take immunosuppressive medications, except the rare recipient of a transplant from an identical twin.
The limited options to pay for expensive immunosuppressive medications negatively impacts patients’ lives and likely play a role in medication nonadherence, resulting as a major cause of transplant failure.
Immunosuppressive medications have been the key to the success of organ transplantation, but the question of how to pay for this expensive therapy has plagued the United States Congress for the past quarter century. Progress to date includes:
In 1972, Congress made treatment of end-stage renal disease (ESRD) a unique entitlement under Medicare.
In 2001, the following bills were introduced before the House and the Senate. Each bill attempts to amend title XVIII of the Social Security Act to provide adequate coverage for immunosuppressive drugs furnished to beneficiaries under the Medicare program that have received an organ transplant:
Although Congress is working on extending the limitations, what the final outcome will be is yet to be seen. In the meantime, we must work to find solutions that can be implemented now.
Transplantation crosses all lines, which means that those people who do not qualify for Medicare or Medicaid will always be in need of adjunct financial assistance.
Organ transplantation is an expensive therapy, even for patients with adequate health insurance. Costs may include travel, lodging, and meals whenever the patient comes to the transplant center for evaluation or follow-up. Out-of-pocket medical expenses usually include premiums, deductibles and co-payments for health insurance. Patients who are unemployed due to illness and no longer qualify for employer sponsored insurance are forced to pay the full cost of insurance premiums if they remain eligible.
Co-payment for the expensive drugs can be sizable. The average cost of immunosuppressive agents may be as high as $10,000 - $14,000 per year for kidney patients. For patients with low family income, these medications and health costs directly compete with the provision of other basic necessities such as food, clothing and shelter.
Medicare eligible patients have immunosuppressive medications paid at 80% for three years, while Medicaid eligible patients are covered for three prescriptions per month. Patients who qualify for pharmaceutical assistance programs have stringent requirements proving insufficient family income. The transplant center must initiate the application and must re-apply every three to six months. Although it appears at first glance that there are many programs to help patients, most have limited access, tough requirements and many are only temporary. Many low-income jobs earn too much to qualify for financial help, yet earn too little to afford private insurance.
With this real need to assist patients with medications, the American Organ Transplantation has developed a program to help fill in the gaps.
Although dramatic improvements have occurred in organ transplantation, all patients must take immunosuppressive medications, except the rare recipient of a transplant from an identical twin.
The limited options to pay for expensive immunosuppressive medications negatively impacts patients’ lives and likely play a role in medication nonadherence, resulting as a major cause of transplant failure.
Immunosuppressive medications have been the key to the success of organ transplantation, but the question of how to pay for this expensive therapy has plagued the United States Congress for the past quarter century. Progress to date includes:
In 1972, Congress made treatment of end-stage renal disease (ESRD) a unique entitlement under Medicare.
- In 1984, Congress passed the National Organ Transplant Act, which authorized payment for immunosuppressive medications for one year after Medicare covered renal transplantation.
- In 1991, Congress authorized payment for transplantation and immunosuppressive medications for heart and liver recipients.
- In 1992, Congress authorized an extension of the time limit for coverage from one to three years.
In 2001, the following bills were introduced before the House and the Senate. Each bill attempts to amend title XVIII of the Social Security Act to provide adequate coverage for immunosuppressive drugs furnished to beneficiaries under the Medicare program that have received an organ transplant:
- S.1204 Comprehensive Immunosuppressive Drug Coverage for Transplant Patients Act of 2001, Introduced by Senators Durbin, Rockefeller, Edwards, Biden Dorgan, Johnson and Levin.
- § S 880 Immunosuppressive Drug Coverage Act of 2001, Introduced by Senators DeWine and Lincoln
- § HR 1839 Immunosuppressive Drug Coverage Act of 2001, Introduced by Representatives Camp and Thurman.\
- § H.R.339 Medicare Outpatient Prescription Drug Coverage Act of 2001, Introduced by Representatives Engel, Frost, Hilliard, Weiner, Nadler and McNulty.
Although Congress is working on extending the limitations, what the final outcome will be is yet to be seen. In the meantime, we must work to find solutions that can be implemented now.
Transplantation crosses all lines, which means that those people who do not qualify for Medicare or Medicaid will always be in need of adjunct financial assistance.
Organ transplantation is an expensive therapy, even for patients with adequate health insurance. Costs may include travel, lodging, and meals whenever the patient comes to the transplant center for evaluation or follow-up. Out-of-pocket medical expenses usually include premiums, deductibles and co-payments for health insurance. Patients who are unemployed due to illness and no longer qualify for employer sponsored insurance are forced to pay the full cost of insurance premiums if they remain eligible.
Co-payment for the expensive drugs can be sizable. The average cost of immunosuppressive agents may be as high as $10,000 - $14,000 per year for kidney patients. For patients with low family income, these medications and health costs directly compete with the provision of other basic necessities such as food, clothing and shelter.
Medicare eligible patients have immunosuppressive medications paid at 80% for three years, while Medicaid eligible patients are covered for three prescriptions per month. Patients who qualify for pharmaceutical assistance programs have stringent requirements proving insufficient family income. The transplant center must initiate the application and must re-apply every three to six months. Although it appears at first glance that there are many programs to help patients, most have limited access, tough requirements and many are only temporary. Many low-income jobs earn too much to qualify for financial help, yet earn too little to afford private insurance.
With this real need to assist patients with medications, the American Organ Transplantation has developed a program to help fill in the gaps.
