Prescription Drug Coverage

 

Prescription coverage is often the number one financial problem patients face after transplant. Immunosuppressant medications are expensive and must be taken for the rest of your life after transplant. Transplant patients generally take many medications immediately following transplant. The number of medications and doses may decrease over time after transplant. After your transplant, you will typically take a combination of immunosuppressive medications, such as:

  • Tacrolimus (Prograf)

  • Sirolimus (Rapamycin)

  • Mycophenolate (Cellcept)

  • Prednisone

  • Mycophenolic acid (myfortic)

  • Cyclosporine (Neoral, Gengraf)

 

In addition to immunosuppressant medications, you may be required to take an antiviral or antifungal medication, such as Valcyte, which can also be expensive. For many insurance plans, these medications are considered specialty medications and can be subject to higher co-pays. It is important prior to your transplant that you contact your insurance company to determine what your co-pays will be for all of your medications. If your out-of-pocket expenses will be limiting, it is important to talk to your financial coordinator or social worker at your transplant center to determine resources they may have to help you with these costs.

 

Additionally, many drug companies provide medicine for patients who need financial assistance. The Medical Assistance Tool can provide you with a list of participating programs in each state. Visit this site or contact your transplant team for help.

 

Questions to ask may include:

  • Am I eligible for your program?

  • Do I need to be referred by my transplant team?

  • How long does it take to get set up with your program?

  • How do I receive the medications?

  • How long am I eligible for your program?