Each year, approximately 350 people diagnosed with a blood cancer or other blood disorder receive a life-saving bone marrow or cord blood transplant at Duke University Medical Center.
Some are fortunate to receive the gift of donation from a family member or anonymous donor. Many others must simply wait and endure the fear and frustration when a cure is possible but remains out of reach.
Although I won’t begin to compare my frustration level with that of my patients, the transplant community has also been enduring something of an agonizing waiting game.
We have been in desperate need of policy updates that would ensure hospitals are adequately reimbursed for cellular transplants that can cure blood cancers like leukemia, lymphoma and Myelodysplastic Syndromes. We have been working with policy makers to help them understand that cellular transplants deserve the same kind of appropriate funding provided for transplants of solid organs, like kidneys, liver and lungs.
We thought we might be close to a much-needed and long-awaited solution. But unfortunately, late last month, the Centers for Medicare & Medicaid Services (CMS) failed to propose a payment policy change for Medicare’s reimbursement of cellular bone marrow, peripheral blood stem cell and cord blood transplants.
As a result, and much to the dismay of the transplant community, the fiscal year 2019 Hospital Inpatient Prospective Payment System (IPPS) proposed rule will not appropriately reimburse donor search and cell acquisition costs for these essential treatments, unless the Congress steps in and changes the policy through legislation.
It’s a decision that makes little sense when you consider the facts.
Joanne Kurtzberg, MD, is the Jerome Harris Distinguished Professor of Pediatrics and professor of pathology at Duke University Medical Center and the director of the Marcus Center for Cellular Cures, the Carolinas Cord Blood Bank, and the Pediatric Blood and Marrow Transplant Program, as well as co-director of the Stem Cell Transplant Laboratory.