Nerlynx (neratinib) — Highmark

Initial criteria

• age ≥ 18 years
• EITHER early-stage HER2-positive breast cancer (ICD-10: C50) AND Nerlynx used as a single agent AND received adjuvant trastuzumab-based therapy OR advanced/metastatic HER2-positive breast cancer (ICD-10: C50) AND Nerlynx used in combination with capecitabine AND received two or more prior anti-HER2 based regimens in the metastatic setting

Reauthorization criteria

• prescriber attests that the member is tolerating therapy
• member has experienced a therapeutic response defined as disease improvement OR delayed disease progression

Approval duration

12 months