Today: Kevin Dwyer Left To Die By Health Insurance Company
You may have heard horror stories about people battling their insurance companies to try and get them to accept their claim, but it probably doesn’t stack up to this one. Kevin Dwyer has cystic fibrosis, a deadly disease that clogs the lungs and can even cause internal breathing. The average lifespan of a patient that his this disease 37 years old, and Kevin is 40.Essentially, Kevin is suffocating to death very slowly, and there is nothing he can do about it.
His sister Martha, though, has the same exact disease, and yet is quite all right, far from the coughing fits that leave her brother bedridden. Martha credits her survival to a little blue pill called Kalydeco, which can slow the disease and even extend the lives of those that have it. However, at $25,000 a month, Kalydeco is hardly an accessible drug.
Today Show: Kevin Turned Down For Life Saving Drug Kalydeco
Kevin Dwyer was turned down for Kalydeco, a medication that he desperately needed.
Where things get bad is where the insurance gets involved. Despite the fact that Kevin and Martha have the same insurance, United Healthcare, the same mutation of cystic fibrosis, and see the same doctor, who wrote the same letter to United Healthcare explaining how both Kevin and Martha could benefit from the drug, Martha was approved, while her brother Kevin was not.
Needless to say, Kevin was baffled by this, and appealed and was denied four times by United, even after he pointed out that his sister, who shared identical circumstances, was approved. United claimed that the drug was not FDA-approved for Kevin’s mutation, but that can’t be true, since it was already proven that Kevin and Martha do, in fact, have the same mutation of cystic fibrosis. Somehow, while Martha’s reviewer said that the drug was “medically necessary” for her health, Kevin’s reviewer said that it was “not medically necessary.”
Today: Healthcare Advocate Elisabeth Benjamin
Healthcare advocate Elisabeth Benjamin said that things like this can’t keep happening. “There needs to be more transparency, more accountability,” she said. “It shouldn’t be luck of the draw.”
Whatever needs to be done, it needs to be done soon. Whereas Kevin was a model of fitness two years ago, he now struggles to make it up a flight of stairs. Kevin doesn’t know what other options he has if he doesn’t get the pill. It’s pretty much a life or death situation at this point.
Today: Kevin Dwyer Approved For Kalydeco
Kevin and his wife, Katie, came on the show this morning and got some very good news, though. Since the story was brought up to United by the media, Kevin has received the drug, the company saying that “unique circumstances” in Kevin’s case got him the drug.
Kevin is relieved that the long, stressful battle is over. Going back to the original phone call he got telling him that he got the drug, Kevin said that, after hanging up the phone in stunned awe, he simply sat there and cried, a wave of relief coming over him.
Kevin’s sister, Martha, said that anyone else going through a similar problem should do your research and keep fighting. Kevin is going to be able to start taking the drug tomorrow, and Martha said that he should feel an improvement in just a few days. Kevin’s new wife is equally relieved, saying that she and Kevin could finally start moving forward with their marriage.
Being the grandmother of a 10 yr old with CF I was happy to hear of a new drug that could extend his precious life. However discouraged at the problems caused by the insurance companies. Not everything should depend on the amount of profit that may be made.