What do they cost?


The pills again.  They cost a LOT of money, but what choice do you have?  There is a trick, though.

If you have coverage as an individual or as a dependent under a good group plan, the cost of medication is usually covered with a co-pay up to whatever annual cap that may exist.

Beyond that, if you are on Medicare, most supplemental Medicare policies "carve out" the two most expensive anti-rejection/immune-suppression medications out of the medical benefit part of your policy's coverage, instead of from the prescription plan part, if you have one.  So Neoral and CellCept, which can together cost roughly $1500-$1800 per month, are usually covered with a small co-pay, provided that you buy them mail-order in 90-day quantities (which you will).  That's the term they use, by the way, "carve out".  It is possible because Medicare permits a carve out of chemotherapy drugs in a similar way, and these medications fall in that general category.

Towards the end of his administration, President Bill Clinton--the best President a patient has ever had--signed into law a modification of Medicare that provides for unlimited free transplant meds, namely Neoral and CellCept.  The limit under Medicare was initially 36 months post-op, which was then extended to 45 months, and then extended by this last law indefinitely.

The rest of the medications you will need may be covered for a period of time until your annual cap kicks in.  For me, that usually happens about ten minutes after the first 90-day shipment, after which I'm on my own, shopping at my favorite transplant-friendly mail-order supplier (formerly Stadtlander's, and now Good Life Resources).

Expenses such as these can be deducted from your taxes, however, to whatever extent the law allows.

There is, however, another approach if you are extremely strapped for cash.  Nearly every pharmaceutical company has a drug assistance program for financially needy patients that cannot pay for their meds.  The programs vary from company to company.  I recently found in the Gift For Life newsletter ( a list of contacts at various drug companies with such programs.  Here are the ones that are, I think, most appropriate for lung transplant patients:

Imuran (Glaxo-Wellcome)  800-722-9294  800-423-6869

CellCept/Cytovene (Hoffman-LaRoche) 800-285-4484  800-526-6367

Mycelex (Bayer Corp)  800-998-9180

Cyclosporin/Sandimmune/Neoral (Novartis) 800-722-9294  800-455-6655

Prednisone (Upjohn)  800-242-7014

Lasix (Hoechst-Marion-Roussel, Inc) 800-362-7466  800-522-3656

There are many others, but these are most of the ones associated with lung transplant meds, from what I can see.  Check out the Gift For Life website (see above) and you may find more help there.

Obviously, this is the greatest challenge facing the post-transplant patient.  However, with care and perseverance, it can be managed.  It is never easy, but it is doable.  As far as I'm concerned, it's nothing to get upset about (right).