AST Raises Concerns about Plans to Limit Medicare Drug Coverage

Wednesday, February 26, 2014

The American Society of Transplantation (AST) Raises Concerns about Plans to Limit Medicare Drug Coverage; Calls Potential Changes “Life-Threatening”

AST strongly opposes the CMS proposed rule to remove immunosuppressant medications as a protected class under Medicare Parts C and D

WASHINGTON, DC – February 26, 2014 – The American Society of Transplantation (AST), representing the majority of professionals engaged in the field of organ transplantation, today expressed their concern about the Centers for Medicare & Medicaid Services (CMS) proposed rule to eliminate immunosuppressive drugs as one of the six protected drug classes in Medicare Part C and D plans. A Congressional Sub-Committee plans to hold a hearing on the proposed changes today and the rule is open for public comment until March 7.

The proposed changes would lift a current requirement that insurers cover almost all of the drugs in certain treatment areas, and many other organizations in the transplant and mental health community have joined AST in voicing their alarm. Timely access to immunosuppressants is essential for patients with transplanted organs and often times therapies in transplantation rely upon the use of multiple drugs whose mechanisms are complementary. AST has pointed out that restricting access to these life-saving medications (or these potential combinations of medications) could lead to increased rates of organ rejection, patient suffering and ultimately even death.

While AST strongly supports the efforts of CMS to reduce health care spending and improve patient care, they believe this particular proposal to prevent patients and physicians access to all immunosuppressive drugs (in every formulary) will not achieve either reduced health care spending or improved patient care. Rather, AST contends that this proposal has the potential to dramatically increase health care costs, profoundly damage the health of transplant patients, and potentially lead to significant patient and family suffering as the result of organ rejection.

Transplant recipients, patients, families or concerned parties are encouraged to voice their concerns directly to CMS by sending their comments before 5 PM EST on Friday, March 7. Comments may be submitted in the following methods:

• Electronically – You may submit electronic comments online (referencing CMS-4159-P) by visiting: http://www.regulations.gov/#!submitComment;D=CMS-2014-0007-0002
• Posted Mail – You may mail written comments to the following address:

Centers for Medicare & Medicaid Services
Department of Health and Human Services
Attention: CMS–4159–P
P.O. Box 8013
Baltimore, MD 21244

For more information about the proposed CMS rule changes to Medicare, or The American Society of Transplantation, please visit: www.myast.org.

About The American Society of Transplantation (AST)
The American Society of Transplantation (AST) is an organization of transplant professionals who are dedicated to advancing the field of transplantation and improving patient care by promoting research, education, advocacy, and organ donation. The Society comprises more than 3,300 transplant physicians, surgeons, scientists and allied health professionals. For more information about the Society, go to www.myast.org.


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