Sick teens in crisis: Organ transplant patients may die when insurance for medicine runs out

A new study from Saint Louis University researchers shows that young transplant patients who lose their federally provided insurance coverage are more likely to stop taking necessary anti-rejection drugs, which can increase the risk of losing the transplanted organs.

The study appears in the March issue of Pediatric Transplantation.

“Immunosuppressive drugs that prevent organ rejection are incredibly expensive; sometimes more than $13,000 a year,” says study author Mark Schnitzler, Ph.D., associate professor in the departments of internal medicine and community health at Saint Louis University. “Even for families with insurance, the co-payments can be a huge financial burden.”

Most healthcare costs associated with transplants in the United States – such as critical immunosuppressive drugs – are covered by Medicare for between 36 and 44 months, after which point they are “cut off,” Schnitzler says. If families cannot afford medicine, it can mean losing the transplanted organ or even death.

Young adults from the ages of 18 to 23 face the greatest risk, as nearly a third of this age group lacks medical coverage. Even when families do have coverage after a transplant, it runs out 36 to 44 months post-transplant or when the child reaches adulthood.

Schnitzler and his team studied the medical records of 1,001 children who underwent kidney transplants between 1995 and 2001, half of whom lost their health insurance. He says the results point to a need for better and more comprehensive health insurance.

“Kids with transplanted kidneys who lose their insurance have nine times a greater chance of dying than those who don’t,” he says. “It is critical that we find a way to offer lifetime access to these children and their families so that our society does not continue to prematurely lose this promising pool of young adults.”

For families trying to make some difficult decisions, Schnitzler advises them to retain their insurance, as the cost of insurance is more affordable in the long term than the expense of transplant failure and hospital stays.

“Pediatric transplant recipients have every desire to become independent and useful members of society. To achieve that goal, they need to keep their transplants healthy, and immunosuppressive drugs are essential to ensure that that happens.”

Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.