Interesting that UC can be in the small intestine.
Well not really. That isn't quite ready for prime time. There are some VERY early papers saying that if just a little of the TI is involved etc the disease can still be UC.
So his disease is similar to O. She has disease now in colon and TI. Same symptoms and her loud symptoms are all the colonic ones.
I just don't get what the nurse was saying then about Remicade and Crohns vs. colitis (I will go back and read it). Remicade works equally as well in both diseases as do the biosimilars. Insurance doesn't really look at Crohn's colitis as a dx to approve or deny meds. They pretty much look at IBD. They will sometimes look at location or a UC vs Crohns dx for particular meds such as the 5 ASA topicals or certain biologics as those that are only approved for UC. I know this now because O needed rectal topicals and they are used much more widely in UC. Her insurance said , "No UC dx" ..yeah don't get me started. So we had to go to steroid topicals.
I honestly think the best shot for appeal is the switch opens him up for reaction to a different formulation. As a matter of fact, our GI explained that Remicade is a large molecule (correct me here MLP) drug and as such it is constantly changing ever so slightly. But it is these changes that over time can lead some people to lose response. So in y mommy opinion, if you can lose response to the same med that is going through slight changes I would assume you leave yourself oen for lack of response when changing to a bio similar.
I am sure your GI can put it in terms they will understand...
Incremental cost of Remicade vs cost of hospitalization due to uncontrolled disease.