Willoughby Lisa M, Fukami Sumina, Bunnapradist Suphamai, Gavard Jeffrey A, Lentine Krista L, Hardinger Karen L, Burroughs Thomas E, Takemoto Steven K, Schnitzler Mark A
Department of Internal Medicine, Center for Outcomes Research, Saint Louis University, St Louis, MO 63104, USA.
Pediatr Transplant. 2007 Mar;11(2):127-31. doi: 10.1111/j.1399-3046.2006.00639.x.
The advent of improved immunosuppression and enhanced allograft outcomes has resulted in a growing number of patients taking expensive immunosuppression medications for the rest of their lives. Healthcare costs for the majority of transplantation procedures in the USA currently are covered by Medicare, but coverage ends for outpatient immunosuppression medications 36-44 months after transplantation. Two or three immunosuppressive agents typically are included in post-transplant regimens with a total annual cost that can exceed 13,000 dollars. This represents a significant financial burden for families no matter if they have adequate health insurance coverage because of co-payment obligations. Evidence suggests that some patients have reduced immunosuppression doses because of an inability to afford their medication, increasing the risk of graft failure. The purpose of this article was to review these and other issues pertaining to medical insurance coverage and transplantation, particularly for adolescent recipients as they transition to adulthood.
免疫抑制的改善和同种异体移植结果的提高，使得越来越多的患者需要终生服用昂贵的免疫抑制药物。目前在美国，大多数移植手术的医疗费用由医疗保险覆盖，但移植后36至44个月的门诊免疫抑制药物费用不在保险范围内。移植后的治疗方案通常包括两三种免疫抑制剂，每年的总费用可能超过13000美元。无论家庭是否有足够的医疗保险，由于需要自付费用，这都给他们带来了沉重的经济负担。有证据表明，一些患者因无力支付药物费用而减少了免疫抑制药物的剂量，从而增加了移植失败的风险。本文的目的是回顾这些以及其他与医疗保险覆盖范围和移植相关的问题，特别是针对青少年受者成年过渡期的情况。
