The financial impact of immunosuppressant expenses on new kidney transplant recipients

Clin Transplant. 2008 Nov-Dec;22(6):738-48. doi: 10.1111/j.1399-0012.2008.00869.x. Epub 2008 Jul 31.


Background: This study aimed to examine kidney transplant recipients' ability to afford transplant-related out-of-pocket expenses and the financial impact of these expenses on their lives.

Patients and methods: This cross-sectional study involved 77 kidney recipients. Variables analyzed were: ability to afford daily necessities; impact of immunosuppressant expenses on patients' lives; awareness of Medicare support terminating three yr post-transplant; and strategies used to pay for out-of-pocket transplant expenses. The Economic Strain Scale measured financial strain.

Results: Twenty-nine percent of kidney recipients experienced financial strain. Poor, less educated, and younger patients were more likely to report financial strain. Out-of-pocket expenses relating to kidney transplantation adversely affected patients' ability to afford leisure activities (35%), a house (27%), and a car (26%). Thirty-one percent reported that immunosuppressant expenses have had somewhat to great (adverse) impact on their lives. Of those on Medicare and not disabled (n = 41), 51% were unaware Medicare coverage will terminate and 71% did not know how long coverage lasts.

Conclusions: Financial strain presents a considerable risk to kidney recipients' ability to purchase immunosuppression. Socioeconomic disparities in recipients' financial strain may be a source of disparities in graft survival. Transplant professionals should better inform transplant candidates about financial consequences of transplantation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Cost of Illness*
  • Cross-Sectional Studies
  • Female
  • Financing, Personal
  • Graft Survival
  • Health Expenditures / statistics & numerical data*
  • Humans
  • Immunosuppressive Agents / economics*
  • Kidney Transplantation / economics*
  • Male
  • Medicare / economics
  • Middle Aged
  • United States


  • Immunosuppressive Agents