Neratinib (Nerlynx)

SELF ADMINISTRATION

Indications for Prior Authorization:

  •  Kinase inhibitor indicated for the extended adjuvant treatment of adult patients with early-stage human epidermal growth factor receptor 2 (HER2) over expressed/amplified breast cancer, to follow adjuvant Herceptin (trastuzumab infusion) based therapy

This medication is not approvable for the following condition(s):

  • Concurrent use of Nerlynx with other medications for adjuvant or neoadjuvant treatment of HER2-positive breast cancer

All of the following must be met as a condition for coverage:

  • Prescribed by an oncologist, AND
  • Patient has early-stage disease, AND
  • Women with HER2-positive breast cancer, AND
  • Completed 1 year of therapy with Herceptin, OR
  • Tried and intolerant to 1 year therapy with Herceptin

Dosing:

  • Recommended dose: 240 mg (6 tablets) orally once daily for 1 year
  • Hepatic Impairment (Child Pugh C): 80 mg (2 tablets) once daily

Approval:

  • One year

Last review date: September 4, 2018