Page 48 - Binder2

supposed to modulate. And once that line is crossed, there’s
no going back.

Her doctor presented the standard options: increase the
dose, add another immunosuppressant, or switch to a
different biologic—one the immune system hadn’t yet
targeted. But none of these were solutions. They were
contingency plans. Workarounds. Attempts to buy time in a
system that still lacks a strategy for what to do when a
therapy stops being seen as medicine and starts being
treated as an invader.

What followed was a familiar cycle: another biologic, a few
months of partial response, more monitoring, more side
effects, and then another slow decline. At each step, hope
narrowed—not because the disease was unbeatable, but
because the therapies weren’t built for long-term immune
cooperation. No one had designed them to stay accepted.
They were designed to work—and that’s not the same
thing.

This experience, recorded in a public case review by the
New York State Department of Financial Services, is not an
outlier. It’s a quiet echo of what happens every day in
clinics around the world. It’s not on the TV commercials.
It’s rarely mentioned in informed consent documents. But
for thousands of patients each year, this is the turning
point: the moment when a high-tech, high-cost therapy
quietly stops working, and the system shrugs.

Because in a market that’s optimized for short-term
efficacy, long-term immune rejection has become an
accepted risk—unspoken, unmanaged, and deeply
human.

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