Formulary guidance and transparency from P&T to point of care


Reality Check on Breast Cancer HR+/HER2+

Market access for hormone receptor-positive, human epidermal growth factor receptor 2-positive (HR+/HER2+) breast cancer treatments reveals differences in payer coverage across each major channel, as well as specific trends in the drug landscape.  

To help make sense of this new research, MMIT's team of experts has analyzed the data for you and summarized the key findings:

  • Payer Insights: Under the pharmacy benefit, about 41% of the lives under commercial formularies are covered with utilization management restrictions
  • Class Trends: In March 2020, the FDA expanded the label of Ontruzant (trastuzumab-dttb) to include the availability of a 420 mg multidose vial. The agency initially approved the Herceptin (trastuzumab) biosimilar from Samsung Bioepis Co. Ltd. in January 2019 as a 150 mg single-dose vial for the adjuvant treatment of human epidermal growth factor receptor 2 (HER2)-overexpressing breast cancer and for metastatic breast cancer, gastric cancer or gastroesophageal junction adenocarcinoma in
    patients who have not received prior treatment
  • Key Findings: It is rare to see a payer place branded products for breast cancer on a preferred tier in the pharmacy benefit, mainly because the majority of products process through the medical benefit

What can pharma do to curb this trend and overcome these challenges?

Get the data behind this change and how it could impact your market access plans from MMIT's team. Their clinical and policy backgrounds provide a unique and expert perspective to help expand your knowledge in the class and guide your decision-making process.

Download the full Reality Check now.