Package advice pertuzumab and trastuzumab (Phesgo®) for the treatment of breast cancer
Zorginstituut Nederland has completed its assessment whether the fixed combined dose of pertuzumab and trastuzumab (Phesgo®) can be included in the insured package. The reason for this advice was the placing of Phesgo® in the so-called lock procedure for expensive medications. Phesgo® is a subcutaneous formulation of 2 medicinal products that have been in existence for a long time, and which have hitherto mainly been applied intravenously. The Zorginstituut advises the Minister to include Phesgo® in the health insurance package after price negotiations.
Registered indication
The registered indication of the fixed combined dose of pertuzumab and trastuzumab for subcutaneous administration (Phesgo®) is for early breast cancer and metastatic breast cancer.
In early stages of breast cancer, Phesgo® is indicated for use in combination with chemotherapy for:
- The neoadjuvant treatment of adult patients with HER2-positive, locally advanced, inflammatory, or early-stage breast cancer with a high risk of recurrence.
- The adjuvant treatment of adult patients with HER2-positive early-stage breast cancer with a high risk of recurrence.
In case of metastasized breast cancer, Phesgo® is indicated for use in combination with docetaxel in adult patients with HER2-positive metastasized or locally recurred, non-resectable breast cancer who have not received prior anti-HER2 therapy or chemotherapy for their metastasized disease.
Zorginstuut's advice
The Zorginstituut advises the Minister to include Phesgo® in the health insurance package after price negotiations. We advise the Minister to take into account the existing discounts for intravenous medicinal products; the net price of Phesgo® can be at most the net price of the intravenous medicinal products currently used.