Although traditional treatment algorithms for Crohn’s disease (CD) and ulcerative colitis (UC) are based on stepwise drug failure, pathways are shifting to a more individualized, risk-stratified approach. There is a perception that insurance policies may not have implemented this paradigm shift (1); particularly regarding access to vedolizumab (VDZ), an anti-α4β7 integrin antibody approved for the treatment of UC and CD. This study evaluated VDZ patient access by analyzing policy information from the Managed Markets Insight & Technology (MMIT) database (2).