Nerlynx (neratinib) — United Healthcare

Initial criteria

• Diagnosis of advanced or metastatic breast cancer AND Disease is HER2-positive AND Patient has received two or more prior anti-HER2 based regimens in metastatic setting AND Will be used in combination with capecitabine
• OR Diagnosis of stage IV (M1) breast cancer AND (HR-positive, HER2-negative disease AND Patient has already received CDK4/6 inhibitor therapy OR Triple negative disease)

Reauthorization criteria

• Patient does not show evidence of progressive disease while on Nerlynx therapy

Approval duration

12 months