Almost all end-stage renal disease patients are covered by Medicare, regardless of age (disclosure: I’ve maintained private insurance throughout my seven years on dialysis). The Renal Support Network recently surveyed more than 800 patients with chronic kidney disease (CKD)—the stages of kidney disease prior to end-stage—about current patient care issues. These CKD patients will almost certainly become either dialysis patients, transplant patients, or both.
Recent testimony at the House Ways and Means subcommittee on health indicated that dialysis patients wouldn’t mind receiving erythropoiesis stimulating agent (ESA) injections subcutaneously. For almost 20 years, these drugs have been administered intravenously through the dialysis line. Subcutaneous injection would require yet another needle stick for dialysis patients with fistulas or grafts. While not nearly as painful as the two 14-gauge needle sticks required for dialysis, another needle stick—even with a small needle—is still another needle stick. Eighty-four percent of survey respondents said they’d prefer the drugs continue to be administered intravenously through the dialysis line.
Survey results also indicated that 62 percent of those patients surveyed are concerned about their ability to get the immunosuppressant drugs necessary to prevent transplanted organ rejection. Medicare currently pays for only three years of treatment. This is one of the most baffling aspects of kidney disease. Medicare pays for transplants in most patients but then only provides three years of the drugs needed to prevent rejection of the organ.
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