A heart transplant should not come with a second battle for survival. Peyton Harres shares what happens when insurance says a life-saving anti-rejection medication is “covered” on paper but still out of reach in real life—and why that gap can become a matter of life and death.
Peyton received a heart transplant at age 11 after living with a rare congenital heart condition and eventually developing heart failure. Now 26, she explains what transplant life looks like long after surgery: daily immunosuppressive medication, ongoing medical monitoring, kidney complications, and the importance of never missing a dose.
Peyton describes how repeated denials for everolimus led to appeals, a last-minute scramble to obtain her medication, and the experience she calls a “ghost approval”: insurance technically approves a drug, but high costs, prior authorizations, specialty-pharmacy rules, or forced mail order still keep it out of reach.
In conversation with host Loretta Boesing, Peyton also discusses the emotional toll of fighting for treatment, the risks of mail-order medication delivery, the role of pharmacists and patient advocates, and changes she hopes lawmakers will make. Together, they explore why transplant patients need meaningful access—not just a promise of coverage—to the medications that help protect their donated organs.
This episode is for transplant recipients, caregivers, pharmacists, patient advocates, and anyone who has had to fight for access to essential medication.
This conversation reflects personal experiences and is not medical advice. Consult your healthcare provider about your own care.