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Why We Need Policies to Promote Good Outcomes for Transplant Patients

Organ transplants save thousands of lives every year, but many recipients are faced with significant challenges to obtaining immunosuppressive medications. This can put the gift of life in jeopardy.

There were a record number of organ transplants in 2019. Nearly 40,000 people in the United States received a life-saving transplant, and more than half were kidney transplants. Currently, nearly 100,000 Americans are waiting for a kidney transplant.


The creation of the End Stage Renal (Kidney) Disease (ESKD) Medicare entitlement in 1972 uniquely recognized patients with ESKD as a vulnerable group that warranted a universal health care entitlement.  This was accomplished by providing ESKD patients access to Medicare. Under current law, a person can qualify for Medicare if they are over 65, disabled, or have kidney disease. Medicare Part B covers the cost of a kidney transplant but ends coverage of anti-rejection medication just 36 months post-transplant if the recipient is not disabled or over 65 years old.

Costly consequences

Since these medications are necessary to prevent rejection, many kidney transplant recipients find themselves struggling to pay for medication after their drug coverage lapses. Unfortunately, some are forced to reduce or forego these essential medications which can result in organ rejection and a return to dialysis. Placing aside the human cost of this policy, the paradox is the fact that society pays for dialysis care and kidney transplantation not only improves and prolongs life it is cost saving for society.  The breakeven point is sometime between 24 and 36 months depending on the type of transplant.

Learn more about routine lab testing for critical patients without requiring visits to a care center.

The American Society of Transplantation (AST) is working with congressional leaders, as well as the entire transplant stakeholder community, to extend the coverage of these immunosuppressive medications beyond the current 36-month limitation set for Medicare Part B patients. In July 2020, the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act (H.R.5534 and S.3353) which would extend this coverage, was marked-up and approved by the House of Representatives full committee on Energy and Commerce. Now, there is an urgent call to action to get this legislation advanced in the Senate.


This legislation would not only save lives and increase the number of kidneys available for transplant. It would save tax dollars since taxpayer-funded dialysis far exceeds the cost of lifelong immunosuppressive medications.   

This legislation has received support from many members of Congress, Committees, as well as the Department of Health & Human Services. To ensure this bill reaches passage, we encourage you to contact your senators at

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