Archive for Wednesday, January 28, 2004

Tough choice

Ex-resident faces dilemma over drug prices

January 28, 2004

Kim Adams Cromer isn't looking for a handout. She's merely looking for a hand up.

The former Tonganoxie resident's been searching for the past several months for medical insurance that she can afford -- and that will help pay her pharmacy bills, which run $1,500 to $2,000 a month.

If she ultimately isn't successful -- and if she is forced to quit taking the medication that's so costly -- her body likely will reject a kidney that her brother donated to her three years ago.

"I will lose my kidney, my kidney," Cromer said. "How can I do that to him. He gave it to me."

Then Cromer, 42, would be forced to undergo dialysis. Ironically, Medicare pays for 100 percent of dialysis costs.

Kim Cromer's story should be a success story, a story of a survivor.

Instead, it's one fraught with frustration and fear.

For the past three years, Cromer has been covered by her former husband's insurance company. But that policy ends Jan. 31. And that's when Cromer's pharmacy bills will soar.

Two years ago, she began researching options.

"I don't want a handout," Cromer said. "I just want to be able to buy it at a reasonable cost."

She's signed up for a state program designed specifically for people like her. It will be helpful, but not solve her financial problems.

She and her husband, Kery, operate a horse-breeding farm south of Pratt. They raise cattle and plant row crops. Kim, a 1979 Tonganoxie High School graduate, works part time at a veterinary clinic. They also are raising five children.

Kim's been so concerned about the financial drain on the family that she's talked with Kery about divorce -- reasoning she could qualify for a government-provided medical card if she weren't married.

"He's just totally against that," she said. "He just won't hear of that."

She's applied for employment at larger companies, ones whose health insurance coverage could handle Cromer's hefty claims. But such companies are rare in her area of Kansas.

She's written numerous letters and made numerous telephone calls, seeking solutions.

"I feel like I've exhausted everything that I know of," she said.

A letter to her current insurance carrier has gone unanswered.

She's been told that, sometimes, pharmaceutical companies will provide extremely expensive drugs at reduced costs. She's filling out applications, in hopes she's approved for such a problem.

Another letter landed on state Insurance Commissioner Sandy Praeger's desk. Praeger's staff helped Cromer hook up with a state high-risk pool, which serves as a safety net for people with extreme health-care costs. Currently, the pool administers about 1,700 Kansans' health care.

"These are heart-breaking, gut-wrenching cases," Praeger said. "We do everything we can to find alternatives for folks."

But, she said, it's not enough.

"For people like Kim, it's still a huge problem," she said.

The insurance commissioner further pointed out that Medicare would pay for anti-rejection drugs for transplant patients for only three years.

"It's crazy," she said.

It's time, Praeger said, that the federal program recognize that transplant patients aren't dying within the first three years after surgery, that they're leading normal, long lives.

Michael Grant, a kidney specialist who is Cromer's physician, couldn't agree more.

"Keeping Kim going with medicine is so much cheaper than dialysis," said Grant, a Wichita physician who also practices in Pratt. "Dialysis costs $60,000 a year. It's much cheaper (for Medicare) to pay for medicine than to pay for dialysis. You would think somebody in Medicare would realize this."

If Cromer stops the anti-rejection drugs, toxins would build up in her blood and ultimately, her body would destroy her brother's kidney. That would mean dialysis. And, possibly, another kidney transplant, which her physician says is physically possible.

"She's young, and she keeps herself in very good shape," Grant said.

But, of course, with a new kidney would come anti-rejection drugs and the whole cycle would start again.

Grant said Cromer's situation is a tragedy.

"She takes her medicine religiously. She does everything the doctors tell her to do. This is what a kidney transplant is made for -- people like Kim," he said.

For Kim's parents, Don and Shirley Adams, who moved from Tonganoxie to Lawrence four years ago, their daughter's situation is a constant worry -- and her fortitude is a source of pride.

"They're farmers," Don Adams said. "This is a tremendous financial burden. But they have a good frame of mind. They don't mope and complain about things. They have a terrific attitude."

That seems to run in the family.

It was Kim's brother Kevin, a 39-year-old Sprint employee, who immediately stepped forward when he found out his sister needed a transplant.

"I always refer to my kidney living in Pratt," Kevin Adams said. "It loves Pratt. It's very happy there."

And he wants it to remain just where it is.

"I did what I did to help her live a happy and healthy life, as much as possible," he said. "It's frustrating to me that the cost of a little bitty pill could stand in the way of her leading a healthy life."

For Cromer, the past few years have been an emotional roller coaster. She's gone from the high of living a healthy life again to the low of wondering whether she will lose that. She often turns to prayer, where she finds comfort and strength.

Still, she doesn't know exactly what the answer is to her dilemma.

"I get up every morning and am thankful that I'm alive and that I feel good and that I have energy," she said. "If you've never been sick and your ability to live a normal life has almost been taken away, I don't think you appreciate that. Every day is a gift for me. I don't want to give that up. I'm willing to work. I'm willing to do anything I need to do to keep that."

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