How do you handle medication management for patients on immunosuppressive therapy who are lost to follow-up?

I typically require one clinical visit at least once a year at minimum to continue prescribing immunotherapy, with a grace period of a few months. If they are lost to follow-up, I cannot ensure safety or clinical efficacy, nor address symptoms or comorbid conditions that worsen their disease. Our team reaches out to patients informing them that because they have not been seen in over 1 year, we won't be able to continue prescribing medications. This will typically prompt patients to schedule follow-up appointments. More rarely, we also find out if care needs to be transferred for insurance reasons, and we can direct them to appropriate resources if they share the reasons for difficulties in keeping appointments (social work, financial).