Expanded use of breast cancer drug Herceptin (trastuzumab) can be effectively tracked by combining pharmacy and medical claims data
Prime Therapeutics analysis finds nearly 76 percent of patients taking Herceptin were treated in early stage breast cancer - important for predicting breast cancer future costs
ST. PAUL, Minn., Oct. 14, 2013 /PRNewswire/ -- Expanded use of the common breast cancer drug Herceptin® (trastuzumab) can be tracked using pharmacy and medical administrative claims data, according to a new analysis by pharmacy benefit manager Prime Therapeutics LLC (Prime). Prime will be presenting the study at the Academy of Managed Care Pharmacy (AMCP)'s Nexus 2013 conference in San Antonio on Oct. 16, 2013.
Herceptin was originally approved to treat metastatic breast cancers with HER2 expression, a protein that promotes growth of cancer cells. Approval was extended to include treatment of early-stage breast cancers in combination with primary surgical treatment, as well as metastatic gastric cancer. Other drugs targeting the HER2 protein have also been approved or are in clinical trials.
Prime's analysis used integrated medical and pharmacy data for 10 million commercial members across 11 health plans from 2010-2012. It was designed to determine whether it is feasible to track expanded Herceptin use with administrative claims (or billing) data.
Prime's health outcomes team found 57 per 100,000 members had primary breast cancer surgery, and 9 per 100,000 members started new Herceptin treatment. Herceptin for early-stage breast cancers (adjuvant or neoadjuvant) was 76% of its use. Approximately 13% of commercially insured members with a primary breast cancer surgery received Herceptin (about 25% of those who received any chemotherapy). The ideal duration of Herceptin therapy is one year at a drug cost of over $70,0001.
"Using claims data, it's possible to track patients who are taking Herceptin for treatment of breast cancer after surgery," said Pat Gleason, PharmD, BCPS, FCCP, director of health outcomes for Prime. "As the number of treatments in this category increases, this analysis shows that it will be possible for insurers to effectively model demand for anti-HER2 treatments to predict use and costs. The high cost of Herceptin treatment requires health plans and plan sponsors to become even more focused on ensuring its use is optimized through evidence-based treatment algorithms, drug distribution channels, contracting activities, and care coordination."
About Prime Therapeutics
Prime Therapeutics LLC (Prime) helps people get the medicine they need to feel better and live well. Prime manages pharmacy benefits for health plans, employers, and government programs including Medicare and Medicaid. The company processes claims and delivers medicine to members, offering clinical services for people with complex medical conditions. Headquartered in St. Paul, Minn., Prime serves nearly 23 million people. It is collectively owned by 13 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans. Prime has been recognized as one of the fastest-growing private companies in the nation.
For more information, visit www.primetherapeutics.com or follow @Prime_PBM on Twitter.
Herceptin is a registered trademark of Genentech, Inc.
1http://www.curetoday.com/index.cfm/fuseaction/news.showNewsArticle/id/5/news_id/3285
| Contact: |
Sheila Thelemann |
| Prime Therapeutics |
|
| Director, Corporate Communication |
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| 612.777.5508 |
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SOURCE Prime Therapeutics LLC
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