A 24-year-old patient covered under a Federal Employee Health Benefits (FEHB) plan was suffering from severe EoE that had already disrupted nutrition, school, and daily life. Before Dupixent, he experienced painful swallowing, food impactions, vomiting, weight loss, anxiety around eating, and repeated treatment failure despite prolonged trials of PPIs, dietary elimination, and oral steroids.

Dupixent was transformative. After starting treatment, the patient experienced major clinical improvement, including easier swallowing, reduced pain, improved nutrition, and clear endoscopic and histologic progress. That progress was suddenly threatened when FEP Blue removed Dupixent from the formulary, creating an immediate treatment gap and putting the patient at risk of relapse.

The client found Claimable through a patient support program and used the platform to submit an appeal after their doctor’s efforts had failed to restore coverage. Claimable’s strategy focused on the clearest facts: Dupixent is the only FDA-approved biologic for EoE, the patient had already failed standard first-line therapies, and no covered alternative offered an equivalent, evidence-based option.

The appeal also highlighted the real-world harm caused by the formulary change. Once coverage was cut off, the patient began missing doses and experiencing the return of swallowing difficulty, pain, and meal-related anxiety. Claimable argued that this was not just an administrative decision, but a direct threat to continuity of care for a patient who had already achieved meaningful disease control.