MIAMI (CBSMiami) – A 23-year-old college student, denied coverage for his cancer treatment, will receive his first round of treatment thanks to community support by way of a funding website.
Manny Alvarez, who last year was diagnosed with a rare form of cancer called alveolar soft part sarcoma, will start his first treatment Wednesday at the Sylvester Comprehensive Cancer Center, his family said.
Alvarez's family released a statement Tuesday that reads, "In response to the incredible outpour of support we have received from our community, family and friends, Manny can start his first treatment. Because Manny's treatment will likely require more than two cycles, our efforts to raise funds will continue. We are in awe of the generosity that has been bestowed on us in the last couple days. Thank you so much for the continued prayers and support. #spearsarcoma"
Funds on the Gofundme page, set up by Alvarez's friends, was over $108,000 Tuesday.
Alvarez's alma mater, Christopher Columbus Senior High School, is also reaching out to alumni for help.
Dr. Breelyn Wilky, a sarcoma specialist and Alvarez's oncologist at Sylvester told CBS4's Maggie Newland on Monday just how rare sarcoma is.
"There's less than 100 cases diagnosed every year in the United States," said Dr. Wilky.
Dr. Wilky told Newland that Alvarez's cancer is so rare, there is no standard treatment, but after he had surgery for a tumor in his knee, researchers found a drug combination that killed tumor cells. Now they want to see if that drug combination will also shrink the tumors throughout his body.
But she says Alvarez's insurance company, Florida Blue, won't pay for the $266,000 treatment.
"I provided them with the data. Unfortunately because these drugs are not approved for sarcoma they were unable to provide coverage," said Wilky.
A statement from Florida Blue, released Monday, reads:
Florida Blue strives to provide our members access to the highest quality medical care. This includes access to pharmaceuticals that are clinically proven and approved for specific treatments by the U.S. Food and Drug Administration (FDA).
At times, our members and/or their physicians inquire about the use of experimental drugs or drugs that have not been adequately tested and approved for a particular use. Florida Blue's team of physicians conducts a thorough review of the proposed treatment. Based on their medical expertise and scientific evidence on the effectiveness of the treatment, they either approve or deny the request.
Members have the right to appeal if they feel their proposed treatment is inappropriately denied. This process includes an internal review of the case by Florida Blue medical professionals, as well as an independent external review by physicians who are experts in the particular medical field. If a case goes to external review, Florida Blue will re-evaluate the appeal once that expert review is received.
With any denial of coverage, Florida Blue works closely and directly with the members and their physicians, providing thorough documentation and medical justification based on available clinical studies and research.
It is important to note that Florida Blue regularly monitors and evaluates new advances in medical and pharmaceutical treatments. We are continually updating our coverage policies based upon ongoing medical research and evidence-based conclusions.
Dr. Wilky says she appealed the decision and Alvarez's family will appeal as well.
For more information, or to help Alvarez's cancer treatment fund, click here.
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