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IMMUNOSUPPRESSIVE DRUG FUNDING THROUGH STATE BLOCK GRANTS

Executive Summary

IMMUNOSUPPRESSIVE DRUG FUNDING THROUGH STATE BLOCK GRANTS is proposed in legislation introduced by Sens. Hatch (R-Utah) and Kennedy (D-Mass.) June 10. The Hatch-Kennedy measure, S 2536, would authorize $15 mil. annually for the drug program from fiscal 1987 through fiscal 1989. In the first two years, funds would be allotted based on each state's ratio of end-stage renal disease patients to the national total. In the third year, allotments would be based on a state's ratio of eligible transplant patients. However, each state would receive at least $50,000 under the measure. According to the bill, states would be able to use the monies to reimburse transplant centers for acquiring immunosuppressive drugs and biologicals, or to actually purchase and distribute the immunosuppressives to the facilities. The bill would bar states from directly reimbursing patients. Sen. Gore (D-Tenn.) introduced a measure June 10 that would provide for federal distribution of drugs to transplant centers. Gore said his bill, S 2540, would "require the government to purchase immunosuppressive drugs and distribute them to transplant centers around the country that meet minimum standards to assure quality of care." The measure would authorize funding of $15 mill. annually for two years, and would limit distribution to centers performing at least 25 transplants per year. Gore's bill essentially endorses a recommendation of the Task Force on Organ Transplantation, which proposes that Medicare funds be provided to the Public Health Service for use in purchasing drugs and distributing them to transplant centers. A similar proposal was contained in earlier versions of the organ transplant law but did not survive House-Senate conference. The administration has strongly opposed such a program on the grounds that Medicare does not pay for any other outpatient drugs. Gore believes that the bulk purchases would lower drug costs and that administrative expenses would be lower than under 50 state programs. The senator said the organ transplant task force "specifically rejected the block grant approach that two of my colleagues have just proposed."
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