New Organs = New Challenges|
A Special Center Helps Patients Deal with Life Before and After Transplant
Barry Marshall will never forget the bone-marrow transplant patient he met when he worked at a Cincinnati hospital 10 years ago. "He'd literally been given 48 hours to live," recalls Marshall. "Just after I met him, his donor match was found and he had his procedure. A few weeks later, I saw him in the hallway and he looked perfectly healthy. I was hooked."
Marshall understood from that day how transplant procedures can give seriously ill people a new lease on life and health. Now, as Vice President of Transplant Services at Westchester Medical Center, he has helped to establish a Transplant Resource Center dedicated to meeting the varied needs of transplant patients before and after their operations.
The center, which opened in January, seeks to educate transplant patients about the procedures and their financial options and to improve their quality of life before and after surgery. It guides transplant candidates through what can be years on the waiting list for a new organ. The center assists them in planning—for example, helping them arrange home care when needed. It helps them find transportation to and from doctor visits. And after their operations, it provides counsel in dealing with what comes next.
Preparing to cover what insurance will not
As Marshall explains, finances can be a big problem for transplant patients. While health insurers and Medicare and Medicaid pay the hundreds of thousands of dollars a transplant operation can cost, they don't always cover post-transplant care, including vital medications to prevent organ rejection. The sad result is that some new organs fail because patients simply can't afford the antirejection drugs and other medications they need.
"Patients are usually on 11 to 12 medications after surgery, and these can have a retail cost of $3,000 to $6,000 a month," says Marshall. "Even with the best insurance, if you pay a flat $20 copay; that's still $220 a month out of pocket. Medicare requires a 20-percent copay, which can be $600 to $1,200 a month—for people who may already be struggling."
Assistance for the working poor
Though the center's direct financial aid to patients so far must be capped at $250 per qualified applicant—"I wish we had a big pot of money, but we don't," says Marshall—the facility also helps patients find other resources, through pharmaceutical companies and such groups as the National Foundation for Transplant, which also have financial assistance programs.
"For example, some drug companies offer antirejection drugs free for the first month," adds Marshall.
The center currently receives most of its funding from the Westchester Medical Center Foundation, but does its own fundraising as well. It hopes to serve between 75 and 125 patients every year, most of them living at or below the poverty level.
"The hardest group to help is the working poor," says Marshall, "because they earn too much for Medicaid, but not enough to support themselves with commercial insurance." Marshall says his goal is simple: "I want to make sure no transplant patient has to choose between food and the medication he or she needs."