Barriers to the Use of Trastuzumab for HER2+ Breast Cancer and the Potential Impact of Biosimilars: A Physician Survey in the United States and Emerging Markets.

Philip Lammers,Ira Jacobs,Giuseppe Curigliano,Carmen Criscitiello

doi:10.3390/ph7090943

Philip Lammers, Ira Jacobs + Show 2 more

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https://doi.org/10.3390/ph7090943

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Abstract

Trastuzumab in combination with chemotherapy has become a standard of care for patients with HER2+ breast cancer. The cost of therapy, however, can limit patient access to trastuzumab in areas with limited financial resources for treatment reimbursement. This study examined access to trastuzumab and identified potential barriers to its use in the United States, Mexico, Turkey, Russia and Brazil via physician survey. The study also investigated if the availability of a biosimilar to trastuzumab would improve access to and use of HER2 monoclonal antibody therapy. Across all countries, a subset of oncologists reported barriers to the use of trastuzumab in a neoadjuvant, adjuvant or metastatic setting. Common barriers to the use of trastuzumab included issues related to insurance coverage, drug availability and cost to the patient. Overall, nearly half of oncologists reported that they would increase the use of HER2 monoclonal antibody therapy across all treatment settings if a lower cost biosimilar to trastuzumab were available. We conclude that the introduction of a biosimilar to trastuzumab may alleviate cost-related barriers to treatment and could increase patient access to HER2-directed therapy in all countries examined.

Highlights

Breast cancer is the most common cancer among women and is the primary cause of cancer death among women worldwide, accounting for ~522,000 deaths in 2012 [1]
Survival rates vary across regions; rates are over 80% in North America, Australia, Sweden, Finland and Japan, ~60% in Brazil, Poland and Slovakia, but below 40% in Algeria [3]
Access to trastuzumab may be a barrier to effective treatment for a large group of patients. With this issue in mind, the objectives of the current study were to examine the level of access that physicians and patients in the U.S, Mexico (MEX), Turkey (TUR), Russia (RUS) and Brazil (BRZ) have to Herceptin and to identify potential barriers that may prevent its use in the treatment of human epidermal growth factor receptor 2 protein (HER2)+

Summary

Introduction

Breast cancer is the most common cancer among women and is the primary cause of cancer death among women worldwide, accounting for ~522,000 deaths in 2012 [1]. Incidence rates differ throughout the world, but rates are highest in developed countries [1]. 235,000 new cases of invasive breast cancer are expected in 2014 [2]. Survival rates vary across regions; rates are over 80% in North America, Australia, Sweden, Finland and Japan, ~60% in Brazil, Poland and Slovakia, but below 40% in Algeria [3]. Low survival rates in less-developed countries may be explained by a lack of early detection programs and poor access to the newest therapies [4]. Even in the U.S, despite advanced detection and treatment programs, it is estimated that approximately 40,000 women will die from breast cancer in 2014 [2]

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