‘I’m going to die a slow death.’ Insurance stops covering man’s life-saving medication

ELK GROVE, Calif. --Mark Dendy has been able to live a normal life thanks to a variety of life-saving medicines, but now he says his insurance company will no longer be covering the sky-high cost of Syprine.

Mark Dendy usually has a healthy sense of humor with the staff and students he tutors at Brightwood College in Sacramento.

Many have no idea that, for Dendy, his work is a distraction from a life-threatening disease that is literally poisoning him from within.

“Without the medicine, I’m going to die a slow death,” he told KTXL.

At 27, Dendy was diagnosed with Wilson’s Disease. It’s an extremely rare disorder that causes copper to accumulate in vital organs like the liver and the brain.

“The prognosis was I’d be dead by the time I was 30,” Dendy said.

Mark is now 64 and has basically lived normal life thanks to a variety of life-saving medicines. For the past 12 years, he’s been on a medication called Syprine.

In July, his insurance company, Sutter Health, informed him it will no longer cover the drug.

What’s worse is that since 2015, the only pharmaceutical company that manufactures it, Bausch Health, increased the price of the medication from $600 to $21,000 for a month’s supply. That’s a more than 3,000 percent increase.

“We’re left with not many options if Sutter continues to deny,” Dendy said. “Where is humanity? Is it all about profits for these big corporations?”

Dendy’s health care plan no longer covers the cost of the drug because his case “did not meet medical necessity” even though not taking it puts him at risk of liver failure, which can be fatal.

Sutter Health sent KTXL a statement echoing this, saying: “This particular medication is in the Sutter Health Plus formulary and is covered if considered medically necessary.”

“I see a neurologist, I see a liver specialist,” Dendy said.

In the meantime, Dendy is trying everything he can to stay alive. He also filed an appeal with Sutter Health over the decision not to cover his medication.

But he has no idea how long that could take, or how long he may have left without his medicine.

“This isn’t about me,” he said. “It’s about being human.”

Bausch Health later sent FOX40 information about its assistance program:

“Our Patient Assistance Program (also called a "PAP") is not a payment plan where someone might pay incremental payments to obtain a good or service, or pay off a loan.

"It's an assistance program in which we offer the medicine to patients with a $5 co-pay per month if they are commercially insured, or they receive the medicine for free if they are uninsured and have incomes of less than 500 percent of the federal poverty level (>$125,000/year for a family of four).  In the first instance, the patient pays $5 per month in total and in the second instance, there is no cost for the patient to receive the medication.”