Dosage & Administration Biomarker testing Drug label Prior authorization Pharmacy Financial assistance

Herceptin

(trastuzumab)

Herceptin 21 MG/ML Injectable SolutionHerceptin 150 MG Injection

BLACK BOX WARNING

Dosage & administration

For intravenous (IV) infusion only. Do not administer as an IV push or bolus.

Do not substitute Herceptin (trastuzumab) for or with ado-trastuzumab emtansine.

Perform HER2 testing using FDA-approved tests by laboratories with demonstrated proficiency.

Adjuvant Treatment of HER2-Overexpressing Breast Cancer

Administer at either:

* Initial dose of 4 mg/kg over 90 minute IV infusion, then 2 mg/kg over 30 minute IV infusion weekly for 12 weeks (with paclitaxel or docetaxel) or 18 weeks (with docetaxel/carboplatin). One week after the last weekly dose of Herceptin, administer 6 mg/kg as an IV infusion over 30–90 minutes every three weeks to complete a total of 52 weeks of therapy, or
* Initial dose of 8 mg/kg over 90 minutes IV infusion, then 6 mg/kg over 30–90 minutes IV infusion every three weeks for 52 weeks.

Metastatic HER2-Overexpressing Breast Cancer

* Initial dose of 4 mg/kg as a 90 minute IV infusion followed by subsequent weekly doses of 2 mg/kg as 30 minute IV infusions.

Metastatic HER2-Overexpressing Gastric Cancer ( 2.2)

* Initial dose of 8 mg/kg over 90 minutes IV infusion, followed by 6 mg/kg over 30 to 90 minutes IV infusion every 3 weeks.

biomarker testing

Herceptin clinical details

Genetic testing requirements were obtained from the NCCN guidelines for each cancer type.

drug label

Herceptin prescribing information

Contact Medical Science Liaison Report Adverse Event

prior authorization

Herceptin prior authorization resources

Most recent Herceptin prior authorization forms

View By Payer

Updated: Jun 06, 2023Highmark BCBS Northeastern NY - Outpatient Herceptin Prior Authorization Form (Medical Benefit)

Updated: Jun 06, 2023Highmark BCBS Western NY - Outpatient Herceptin Prior Authorization Form (Medical Benefit)

Updated: Jun 05, 2023Highmark BCBS West Virginia - Outpatient Herception Prior Authorization Form (Medical Benefit)

Updated: Jun 05, 2023Highmark BCBS Delaware - Outpatient Herceptin Prior Authorization Form (Medical Benefit)

Updated: Jun 05, 2023Highmark BCBS Central PA - Outpatient Herceptin Prior Authorization Form (Medical Benefit)

Updated: Jun 04, 2023Highmark BCBS Western PA - Outpatient Herceptin Prior Authorization Form (Medical Benefit)

Updated: May 31, 2023Cigna - Herceptin Prior Authorization Form

Updated: May 29, 2023Blue Cross Blue Shield of Michigan - Oncology Biosimilar Prior Authorization Form (Medical Benefit)

Updated: May 24, 2023Aetna - Herceptin Prior Authorization Form

Updated: May 23, 2023Aetna - Medicare Part B Herceptin/Herceptin Hylecta Prior Authorization Form

OTHERComplete Letter of Medical Necessity

OTHERCoverage Authorization Appeals

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Benefits investigation

PDFPrescriber Service & Patient Consent Form

Prescriber Service Form - Online Portal

PDFPatient Consent Form - English

PDFPatient Consent Form - Spanish

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Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information

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pharmacy

Herceptin preferred pharmacy

OTHERPharmacy List

financial assistance

Herceptin financial assistance options

Co-pay savings program

commercial only

PDFPrescriber Service & Patient Consent Form

Prescriber Service Form - Online Portal

PDFPatient Consent Form - English

PDFPatient Consent Form - Spanish

Enroll in Patient Savings Program

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Overview

Reduce patient OOP costs for drug (and occasionally for drug administration/infusion costs or drug-related test costs)

Patient benefit

A portion (or all) of patient OOP (deductible, copay), typically up to monthly and/or annual max

Patient eligibility

Patient must enroll or activate (may permit HCPs to enroll on patient’s behalf for HCP-administered drugs)
Generally, must have commercial insurance (rarely, may permit uninsured patients to use)
May never be used with government insurance

How to sign up

Cards may be downloadable digital cards or hard copies
Some pharmacos offer debit cards with pre-loaded copay benefit
Typically, available through multiple channels (e.g., rep to HCP to patient; pharmacy to patient; patient via website, Hub live agent, or copay vendor (live agent or IVR); patient and HCP via Hub enrollment form)
Some HCP-administered product programs permit HCPs to enroll on a patient’s behalf through via Hub form

Foundation programs

under insured

no insurance

goverment insurance

65+

PDFPrescriber Service & Patient Consent Form

Prescriber Service Form - Online Portal

PDFPatient Consent Form - English

PDFPatient Consent Form - Spanish

PDFGenentech Prescriber Foundation Form

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Overview

Charitable 501(c)(3) organizations provide direct cost-sharing and other support (e.g., travel, counseling) through disease-state funds to indigent patients on first-come first-served basis
These organizations may receive financial contributions from drug manaufacturers for particular disease-state funds that cannot provide funds directly to patients - the foundation must be independent/unaligned

Patient benefit

Patients apply for grants that cover a portion (or all) of their out-of-pocket costs (deductibles and co-pays) until the grant is exhausted

Patient eligibility

Patients must apply and meet eligibility criteria including income level (typically a multiple of federal poverty line), specific diagnosis, insurance status, etc.

How to sign up

Patients submit proof of out-of-pocket drug costs to charities for reimbursement

patient education

Herceptin patient education

Getting started on Herceptin

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link