The recent news of veteran TV journalist Tom Brokaw being diagnosed with multiple myeloma sparked interest in this rare form of cancer. Approximately 20,000 people are diagnosed annually with multiple myeloma cancer of the plasma cells in the bodys bone marrow. These abnormal plasma cells dont produce antibodies, so the immune system cant fight off infections.

Like Brokaw, who is 74, the majority of people diagnosed with multiple myeloma as well as more common blood cancers such as leukemia and lymphoma are older than 65. That means that many of these patients depend on Medicare to pay for their treatment, which often includes a blood or bone marrow transplant (BMT).

Ten years ago, patients older than 55 were commonly excluded from this treatment option. Today, because of medical advances, the Medicare population is the fastest-growing segment of patients in most BMT programs in the United States.

However, because of Medicare coverage restrictions, many patients who need a transplant are unable to receive treatment unless they are in the financial position to pay privately for their care.

The financial burden is even more significant when a transplant requires the use of donated stem cells, often needed for those with blood cancers such as leukemia and lymphoma. Because of a difference in the way that Medicare reimburses hospitals for BMT in comparison with solid organ transplantation, each BMT using donor cells results in a substantial financial loss to the hospital providing care.

The financial loss per transplant case is large enough that it is unsustainable, cannot be offset by private insurance payments and is threatening our ability to continue to deliver this vital therapy to those who need it most.

Our clinical success in finding ways to treat older patients has created an unfortunate, but very real, financial threat to the continued existence of our field. In December, we began a dialogue with our partners at Medicare to remedy this situation and hope that continued discussions will result in a correction of the rate-setting methodology currently used.

We are mindful that BMT is an expensive therapy. There is no question that expert teams and significant resources are required. But it is also a lifesaving therapy. Currently, there are more than 100,000 transplant survivors in the United States. With continuing advances in the use of transplant, we project 250,000 by 2020 and 500,000 by 2030 with a quarter of the survivors being over 60 years old.

These costs would not disappear if this treatment were not available. The costs of providing alternate therapies that do not have the potential to be curative are significant. Older patients deserve continued access to therapies that will provide them with the best chance of enjoying more well-earned years of high-quality life with their families and friends.

This month, the American Society for Blood and Marrow Transplantation (ASBMT) celebrates 20 years since its founding. We represent nearly 2,000 transplant clinicians and health care professionals worldwide. Recently we gathered in Dallas for our annual meeting to share cutting-edge research and knowledge, continuing our quest to be the best in the world at what we do for the sake of our patients.

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Blood, marrow transplants must be kept accessible