| Carcinoma breast stage IV
Ixempra vs Perjeta
Side-by-side clinical, coverage, and cost comparison for carcinoma breast stage iv.Deep comparison between: Ixempra vs Perjeta with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsPerjeta has a higher rate of injection site reactions vs Ixempra based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Perjeta but not Ixempra, including UnitedHealthcare
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Category
Ixempra
Perjeta
At A Glance
IV infusion
Every 3 weeks
Microtubule inhibitor (epothilone analog)
IV infusion
Every 3 weeks
HER2/neu receptor antagonist
Indications
- Carcinoma breast stage IV
- Locally advanced breast cancer
- Carcinoma breast stage IV
- Locally Advanced Breast Carcinoma
- Inflammatory Breast Carcinoma
- Early Stage HER2-Positive Breast Carcinoma
Dosing
Carcinoma breast stage IV, Locally advanced breast cancer (with capecitabine) 40 mg/m2 IV over 3 hours every 3 weeks; capecitabine 1000 mg/m2 twice daily for 2 weeks per cycle.
Carcinoma breast stage IV, Locally advanced breast cancer (single agent) 40 mg/m2 IV over 3 hours every 3 weeks.
Carcinoma breast stage IV Initial 840 mg IV over 60 min, then 420 mg IV every 3 weeks; administered with trastuzumab and docetaxel.
Locally Advanced Breast Carcinoma, Inflammatory Breast Carcinoma, Early Stage HER2-Positive Breast Carcinoma Initial 840 mg IV, then 420 mg IV every 3 weeks with trastuzumab and chemotherapy; neoadjuvant: 3-6 preoperative cycles followed by postoperative continuation to complete 1 year; adjuvant: 1 year total (up to 18 cycles), starting Day 1 of first taxane-containing cycle.
Contraindications
- Neutrophil count <1500 cells/mm3 or platelet count <100,000 cells/mm3
- History of severe hypersensitivity to agents containing Cremophor EL or its derivatives (e.g., polyoxyethylated castor oil)
- Combination with capecitabine in patients with AST or ALT >2.5 x ULN or bilirubin >1 x ULN
- Known hypersensitivity to pertuzumab or any of its excipients
Adverse Reactions
Most common (>=20%) Peripheral sensory neuropathy, fatigue/asthenia, myalgia/arthralgia, alopecia, nausea, vomiting, stomatitis/mucositis, diarrhea, musculoskeletal pain; in combination therapy also: palmar-plantar erythrodysesthesia, anorexia, abdominal pain, nail disorder, constipation.
Most common hematologic (>40%) Neutropenia, leukopenia, anemia, thrombocytopenia.
Serious Peripheral neuropathy, myelosuppression, hypersensitivity reactions, cardiac adverse reactions (myocardial infarction, arrhythmia, left ventricular dysfunction), sepsis, pneumonia, respiratory failure, acute hepatic failure.
Postmarketing Radiation recall.
Most common (>30%) diarrhea, alopecia, neutropenia, nausea, fatigue, rash, peripheral neuropathy
Serious neutropenia, febrile neutropenia, leukopenia, diarrhea, peripheral neuropathy, anemia, asthenia, fatigue
Pharmacology
Ixabepilone is a semi-synthetic analog of epothilone B that binds directly to beta-tubulin subunits on microtubules, suppressing microtubule dynamic instability and blocking cells in the mitotic phase of the cell division cycle, leading to cell death.
Pertuzumab is a HER2/neu receptor antagonist that blocks ligand-dependent heterodimerization of HER2 with other HER family members (EGFR, HER3, HER4), inhibiting MAP kinase and PI3K signaling pathways to cause cell growth arrest and apoptosis; it also mediates antibody-dependent cell-mediated cytotoxicity (ADCC).
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Most Common Insurance
Anthem BCBS
Ixempra
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
Perjeta
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Ixempra
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Perjeta
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Ixempra
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Perjeta
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Breast Cancer
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Perjeta.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.