Health Care

Kevin Dwyer Wins Fight Against Insurance Company For Life-Saving Cystic Fibrosis Drug

| by Sylvan Lane
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Kevin Dwyer and his sister, Martha, both have the same mutation of cystic fibrosis. They’ve both outlived the average lifespan of someone with the disease in which the lungs become clogged with mucus, and they both applied to the same insurance company for coverage for a drug that would save their lives. But until just recently, only Martha was approved for it.

Kevin, 40, asked for coverage for the drug Kalydeco, which costs $25,000 and would prolong his life and prevent him from slowly suffocating to death.

According to The TODAY Show, “Kevin and Martha, brother and sister, asked their insurance to cover it. They have the same insurance company: United Healthcare. They have the same mutation of cystic fibrosis. They see the same doctor, who wrote the same letter to United: that both will likely ‘benefit from treatment with Kalydeco.’ But in a stunning twist, Martha was approved and Kevin was denied.”

"It crushed me," Kevin told TODAY. "I mean, I, I was devastated, I was baffled. If I don't get this medication, I don't know what other options I would have. It is completely life and death."

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When TODAY contacted United Healthcare, it reversed its decision and approved Dwyer for the drug. He said that he expects to start the drug Wednesday, and said, "There was a moment after I hung up where I sat stunned in silence and then I just cried. All these emotions, joy, relief came out. This was a big effort."

In 2011, Dwyer ran the New York City Marathon and proposed to his girlfriend, Kate.

Sources: The TODAY Show, The Huffington Post