Admissibility of medicine for claim
Ujvira (T-DM1) or trastusumab-emtansine to treat Her2 + CA Breast in adjuvant treatment is prescribed as protocol by treating doctor. Insurer rejects claim on grounds that it is "mono clonal antibody" and hence exceeded sublimits. whereas , its a conjugate biosimilar of the two medicines mentioned above. Can you please clarify?