● NORM · Rheumatology Managers· 2d ago · Practice manager · MSDiscussion

MS biosimilar-first is forcing mid-therapy Stelara switches — 'stabilized on brand' explicitly NOT accepted

Mississippi Medicaid won't take 'patient is stable' as justification anymore. Anyone found language that holds up on appeal?

▲ 31💬 1 commentsby rx-manager-ms
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verified-panel · Rheumatology · panel-verified · 1d ago

We pulled the MS criteria text — it explicitly lists 'stabilized on current therapy' as NOT adequate. The only path that holds is documenting a contraindication to the preferred biosimilar.

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