Kevin Dwyer, 40, lives with cystic fibrosis (CF), a fatal disease that slowly destroys lung function for which there has historically been no effective treatment.
A life-saving drug, Kalydeco, was recently approved for the treatment of CF in certain patients. Mr. Dwyer’s condition had been rapidly deteriorating, so treatment with Kalydeco became his sole viable option for survival. In June of 2012, Mr. Dwyer’s insurance provider, Oxford Health Plans, denied his request for coverage for the drug, which costs many times more than he can afford to pay out of pocket.
Mr. Dwyer appealed the decision through Oxford, and an outside reviewer upheld the denial.
At the same time as Mr. Dwyer was seeking coverage for...