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Common PA criteria across major payers typically include: Confirmed diagnosis of moderately to severely active ulcerative colitis or Crohn’s disease, documented by endoscopic or clinical assessment Failure or contraindication to at least one conventional therapy (corticosteroids, immunomodulators) and often one TNF inhibitor Prescribing physician is a gastroenterologist or qualified specialist Baseline laboratory workup completed (tuberculosis screening, hepatitis B serology) Home infusion reimbursement rules differ from outpatient infusion billing
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