Researchers from University of Minnesota analyzed Medicare‐covered, kidney‐alone recipients aged 65 years or older and assessed the timing of Medicare loss post-transplant
Medicare offers coverage to people with End-Stage Renal Disease (ESRD). The coverage includes people of all ages, including children. For adults 65 years of age or older or those under 65 and disabled and already have Medicare, coverage for dialysis is offered immediately. However, the coverage ends after three years of transplantation. Now, a team of researchers from University of Minnesota studied 78,861 Medicare-covered kidney transplant recipients under 65 years of age and found that failure of the transplanted kidney was 990% to 1630% higher for recipients who lost Medicare coverage before three-year time point compared with recipients who lost Medicare on time. The study further stated that patients that lost coverage after three years had a increased risk of kidney failure.
The research was published in the American Journal of Transplantation on March 5, 2019. The study also reported that recipients who lost Medicare coverage before or after the three-year time point also filled immunosuppressive medications at a significantly lower rate compared to those who lost coverage on time. The team used data from the Scientific Registry of Transplant Recipients (SRTR), US Renal Data System, and Symphony pharmacy fill database. The team evaluated the timing of Medicare loss post-transplant in three types: less than three years (early), at three years (on‐time), or more than three years (late). Medication possession ratio (MPR) was used to measure immunosuppressant use in recipients. The team also used SRTR data to evaluate allograft loss.
The team found that MPR was lesser for recipients with early or late Medicare loss compared with no coverage loss for all immunosuppressive medication types. Early Medicare loss was related with a 53% to 86% lower MPR for calcineurin inhibitors. However, on‐time Medicare loss was not linked with a lower MPR. The team matched recipients by age and found that post-transplant timing of Medicare loss and donor risk, the hazard of allograft loss was 990% to 1630% higher after early Medicare loss, and 140% to 740% higher after late Medicare loss, with no difference in the hazard for on‐time Medicare loss. The team concluded that proper ongoing Medicare access before and after three years post-transplant can impact graft survival.