Secular Trends in the Cost of Immunosuppressants after Solid Organ Transplantation in the United States

Generic medications reduce the lifetime costs of organ transplantation

The priceless gift of a transplanted organ comes with life-long costs of the critical immunosuppressant medications that prevent rejection. Although Medicare provides coverage for these drugs to kidney transplant recipients in the three years following a transplant, many transplant recipients have difficulty affording the related out-of-pocket costs post-transplantation.

Findings of a study conducted by Arbor Research Collaborative for Health indicate the potential of relief for these patients and Medicare. This work by Margaret E. Helmuth and her colleagues was published February 28, 2019, in the Clinical Journal of the American Society of Nephrology (CJASN). They examined cost changes following the introduction of generic variations of two commonly prescribed immunosuppressants and determined that the introduction of generic medications in this class has resulted in substantial savings for transplant patients and Medicare.

Uptake of Generic vs Brand Name Immunosuppressants Among US Organ Transplant Recipients

After an organ transplant, a transplant recipient must take immunosuppressive medications to reduce the risk of their body rejecting the transplanted organ. Although using therapeutically equivalent generic medications can reduce financial burden, the transplant community has expressed caution about substituting these for brand-name immunosuppressants.

Increased risk of bile duct complications for some living donor liver transplantation recipients

With a critical shortage of donated organs, living donor liver transplantation (LDLT) has become widely accepted in the US as a potential alternative to deceased organ transplant. However, LDLT is a technically challenging procedure that requires sophisticated training, which has limited the growth of LDLT programs. To add to the knowledge in this area and help guide surgical decisions, researchers compared outcomes and complications after surgery for different LDLT approaches.

The long-term psychosocial impact of liver donation

In order for potential liver donors to be fully informed about the risks of donation, they need to have information about the long-term impacts of donation. Studies have examined liver donors’ long-term medical outcomes, but there have been no analogous studies on long-term psychosocial outcomes. To address this gap, researchers examined data from the Adult to Adult Living Donor Liver Transplantation Cohort Study-2 (A2ALL-2) to learn about clinically significant mental health problems and self-reported physical health problems in the long-term years after liver donation.

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