Patient controlled years with uc without flares on asacol (mesalamine).now, insurance won't pay unless patient fails trial of generic balsalazide.refer back to gi?

What a shame!: You may have success getting Asacol (mesalamine) HD or a suitable similar 5-ASA approved on appeal for health plan coverage as a policy exception since the patient has done so well with it for so long. Or, prescribe the balsalazide (Colazal) alternatively. As an aside, is the patient with ulcerative colitis in question due for dysplasia surveillance now, in which case he/she deserves a GI referral anyway?

I would ...: Unless you feel comfortable managing IBD with 5-aminosalicylic acid derivatives, then by all means go ahead. This way if she/he doesn't tolerate the switch over, the GI doc can address the need for a med prior authorization. Alternatively, you could save the patient a referral visit by discussing this with his/her GI doc over the phone and making a contingency plan this way. Best of luck