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OUTPATIENT IMMUNOSUPPRESSIVE DRUG FUNDING

Executive Summary

OUTPATIENT IMMUNOSUPPRESSIVE DRUG FUNDING would be provided by the federal government under legislation soon to be introduced by Sen. Gore. The Tennessee Democrat, who cosponsored the organ transplant act while a member of the House, is considering legislation to provide immunosuppressants for patients who participated in cyclosporine trials, as well as for Medicare-eligible patients, and to limit the program to centers that perform a large number of transplants. The proposal is expected to fall somewhere between the recommendations of the HHS Task Force on Organ Transplantation, which sent its report on access to immunosuppressive therapies to Congress Oct. 25, and provisions in earlier versions of the transplant act. The HHS task force recommended that outpatient immunosuppressants for Medicare transplantation patients be purchased by the federal government, at a cost of between $9.5 mil. and $20.7 mil. in 1986 and between $11.6 mil. and $27.2 mil. in 1987. The panel's projections, which use estimates for both six-month and indefinite cyclosporine treatment regimens, assume that 15% to 20% of eligible patients will need some assistance in meeting transplant and aftercare costs. The panel also recommended that reimbursement not be limited to cyclosporine. This "could have an adverse impact on the development, clinical evaluation and use of immunosuppressive therapies by essentially sanctioning cyclosporine as the preferred mode of immunosuppression," the report states. The task force expects to issue its final report in early 1986. It will include a discussion of access to transplantation and the establishment of an organ procurement network.

OUTPATIENT IMMUNOSUPPRESSIVE DRUG FUNDING would be provided by the federal government under legislation soon to be introduced by Sen. Gore. The Tennessee Democrat, who cosponsored the organ transplant act while a member of the House, is considering legislation to provide immunosuppressants for patients who participated in cyclosporine trials, as well as for Medicare-eligible patients, and to limit the program to centers that perform a large number of transplants.

The proposal is expected to fall somewhere between the recommendations of the HHS Task Force on Organ Transplantation, which sent its report on access to immunosuppressive therapies to Congress Oct. 25, and provisions in earlier versions of the transplant act.

The HHS task force recommended that outpatient immunosuppressants for Medicare transplantation patients be purchased by the federal government, at a cost of between $9.5 mil. and $20.7 mil. in 1986 and between $11.6 mil. and $27.2 mil. in 1987.

The panel's projections, which use estimates for both six-month and indefinite cyclosporine treatment regimens, assume that 15% to 20% of eligible patients will need some assistance in meeting transplant and aftercare costs.

The panel also recommended that reimbursement not be limited to cyclosporine. This "could have an adverse impact on the development, clinical evaluation and use of immunosuppressive therapies by essentially sanctioning cyclosporine as the preferred mode of immunosuppression," the report states. The task force expects to issue its final report in early 1986. It will include a discussion of access to transplantation and the establishment of an organ procurement network.

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