| HER2-positive carcinoma of breast
Margenza vs Nerlynx
Side-by-side clinical, coverage, and cost comparison for her2-positive carcinoma of breast.Deep comparison between: Margenza vs Nerlynx 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 signalsNerlynx has a higher rate of injection site reactions vs Margenza based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Nerlynx but not Margenza, including UnitedHealthcare
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Category
Margenza
Nerlynx
At A Glance
IV infusion
Every 3 weeks
HER2/neu receptor antagonist
Oral
Once daily
pan-HER kinase inhibitor
Indications
- HER2-positive carcinoma of breast
- HER2-positive carcinoma of breast
Dosing
HER2-positive carcinoma of breast 15 mg/kg IV infusion every 3 weeks (21-day cycle) until disease progression or unacceptable toxicity; initial dose over 120 minutes, subsequent doses over a minimum of 30 minutes.
HER2-positive carcinoma of breast (extended adjuvant, early-stage) 240 mg (6 tablets) orally once daily with food, continuously until disease recurrence or for up to one year; reduce starting dose to 80 mg in severe hepatic impairment (Child Pugh C).
HER2-positive carcinoma of breast (advanced or metastatic) 240 mg (6 tablets) orally once daily with food on Days 1-21 of a 21-day cycle plus capecitabine 750 mg/m2 orally twice daily on Days 1-14 of a 21-day cycle until disease progression or unacceptable toxicities.
Contraindications
—
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Adverse Reactions
Most common (>10%) Fatigue/asthenia, nausea, diarrhea, vomiting, constipation, abdominal pain, pyrexia, headache, alopecia, peripheral neuropathy, decreased appetite, cough, arthralgia/myalgia, dyspnea, infusion-related reaction, palmar-plantar erythrodysesthesia, extremity pain
Serious Febrile neutropenia, neutropenia/neutrophil count decrease, infusion-related reactions, left ventricular dysfunction
Most common (>=5%) Diarrhea, nausea, abdominal pain, fatigue, vomiting, rash, stomatitis, decreased appetite, muscle spasms, dyspepsia, AST or ALT increased, nail disorder, dry skin, abdominal distension, epistaxis, weight decreased, urinary tract infection
Serious Diarrhea, vomiting, nausea, dehydration, acute kidney injury, cellulitis, renal failure, erysipelas, ALT increased, AST increased, fatigue, abdominal pain
Pharmacology
HER2/neu receptor antagonist; chimeric Fc-engineered IgG1 kappa monoclonal antibody that binds to the HER2 extracellular domain, inhibits tumor cell proliferation, reduces HER2 shedding, and mediates ADCC via enhanced binding to activating Fc receptor FCGR3A and decreased binding to inhibitory FCGR2B.
Neratinib is an irreversible intracellular kinase inhibitor that binds to EGFR, HER2, and HER4, reducing EGFR and HER2 autophosphorylation and downstream MAPK and AKT signaling pathways.
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Most Common Insurance
Anthem BCBS
Margenza
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (0/12)
Nerlynx
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Margenza
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Nerlynx
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (3/8)
Humana
Margenza
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Nerlynx
- 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
$10/fillfill
Nerlynx Co-pay CardCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.