Ted Fristrom, 52, an English professor who lives in Bala Cynwyd, Pa., has severe nasal polyps and asthma. In 2019, he began taking Dupixent, an injectable drug that transformed his life, allowing him to breathe, smell and stop using asthma and sinus medications. In October 2022, his Dupixent prescription needed to be authorized again, but calls to his insurer, his doctors and the pharmacy went nowhere, and coverage was denied. He went off the drug, and his asthma and breathing troubles returned.
This ear-nose-throat specialist I had been seeing for 20 years had performed three major surgeries on me. It’s kind of like having low-key covid all the time — this dry hacking cough. My sinus polyps would cover my sinuses, to the point there was no air. I did have one serious infection probably related to my sinuses 12 years ago — that ended up becoming bacterial meningitis.
During [the pandemic], the doctor who originally prescribed the drug retired. I had someone who filled in with me with one telemedicine call and successfully renewed the [prescription] one time. But the next time, something got gummed up in the process. I kept calling them and not getting any responses. This is the thing I never understood, how big a deal the paperwork was.
When they cut me off [in October 2022], I had no safety net whatsoever, no prescriptions for asthma. I was waiting for the drug to wear off. The coughing was gradually getting worse. I’d take two covid tests every week just to make sure it’s the sinus polyps and not omicron. It wasn’t until the second or third week of January that I got it approved. Three months.
The meningitis did leave me with a mild case of PTSD, which is usually triggered by calling people about insurance. It took me a while to figure this out. I get unusually irritated by talking to people on insurance lines. I always thought it was righteous indignation, but after awhile I was realizing, I’ve never felt this unmitigated rage at anyone over something that seems so trivial.
I estimated I spent at least 24 hours on the phone. And most of it would be waiting for someone to pick up the line. At least I know what I’m doing now. I’m choosing [a new ENT specialist] I know has done paperwork for Dupixent. That’s the only criteria I care about.
