| Carcinoma breast stage IV
Verzenio vs Phesgo
Side-by-side clinical, coverage, and cost comparison for carcinoma breast stage iv.Deep comparison between: Verzenio vs Phesgo 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 signalsPhesgo has a higher rate of injection site reactions vs Verzenio based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Phesgo but not Verzenio, including UnitedHealthcare
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Category
Verzenio
Phesgo
At A Glance
Oral
Twice daily
CDK4/6 inhibitor
SC injection
Every 3 weeks
HER2/neu receptor antagonist
Indications
- Malignant neoplasm of breast
- Carcinoma breast stage IV
- HER2-positive carcinoma of breast
- Inflammatory Breast Carcinoma
- Locally advanced breast cancer
- Carcinoma breast stage IV
Dosing
Malignant neoplasm of breast 150 mg orally twice daily in combination with tamoxifen or an aromatase inhibitor for 2 years as adjuvant treatment (or until disease recurrence or unacceptable toxicity).
Carcinoma breast stage IV 150 mg orally twice daily in combination with an aromatase inhibitor (initial therapy) or fulvestrant (after endocrine therapy progression); 200 mg orally twice daily as monotherapy (after endocrine therapy and prior chemotherapy); continue until disease progression or unacceptable toxicity.
HER2-positive carcinoma of breast, Inflammatory Breast Carcinoma, Locally advanced breast cancer Initial dose 1,200 mg pertuzumab / 600 mg trastuzumab / 30,000 units hyaluronidase SC over ~8 min, then maintenance 600 mg pertuzumab / 600 mg trastuzumab / 20,000 units hyaluronidase SC over ~5 min every 3 weeks with chemotherapy; neoadjuvant: 3-6 preoperative cycles then continue to complete 18 total cycles; adjuvant: up to 18 cycles (1 year) starting Day 1 of first taxane-containing cycle.
Carcinoma breast stage IV Initial dose 1,200 mg pertuzumab / 600 mg trastuzumab / 30,000 units hyaluronidase SC over ~8 min, then maintenance 600 mg pertuzumab / 600 mg trastuzumab / 20,000 units hyaluronidase SC over ~5 min every 3 weeks with docetaxel until disease progression or unmanageable toxicity.
Contraindications
—
- Known hypersensitivity to pertuzumab, trastuzumab, hyaluronidase, or any excipient of PHESGO
Adverse Reactions
Most common (>=20%) diarrhea, neutropenia, nausea, abdominal pain, infections, fatigue, anemia, leukopenia, decreased appetite, vomiting, headache, alopecia, thrombocytopenia
Serious neutropenia, diarrhea, interstitial lung disease/pneumonitis, hepatotoxicity, venous thromboembolism
Postmarketing interstitial lung disease/pneumonitis
Most common (>=5%) Alopecia, nausea, diarrhea, anemia, asthenia, fatigue, stomatitis, myalgia, arthralgia, neutropenia, vomiting, constipation, headache, dysgeusia, decreased appetite, peripheral sensory neuropathy, mucosal inflammation, injection site reaction, radiation skin injury, insomnia, cough
Serious Febrile neutropenia, neutropenic sepsis, neutrophil count decreased, cardiomyopathy, pulmonary toxicity
Postmarketing Glomerulopathy, immune thrombocytopenia, tumor lysis syndrome
Pharmacology
Abemaciclib is an inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6); in ER-positive breast cancer cells, it blocks Rb phosphorylation and cell cycle progression from G1 into S phase, resulting in senescence and apoptosis.
Pertuzumab blocks HER2 heterodimerization at subdomain II to inhibit MAP kinase and PI3K signaling, trastuzumab binds subdomain IV to inhibit HER2-mediated cell proliferation, and together they augment antibody-dependent cell-mediated cytotoxicity against HER2-overexpressing tumor cells; hyaluronidase transiently depolymerizes hyaluronan to increase subcutaneous tissue permeability and enable systemic absorption.
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Most Common Insurance
Anthem BCBS
Verzenio
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (11/12)
Phesgo
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Verzenio
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (7/8)
Phesgo
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Verzenio
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Phesgo
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Breast Cancer
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: Breast Cancer
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.