Maybe this will help. I know we got Blue Cross in Washington State to cover Perjeta. This link is Blue Cross policy re pertuzumab (perjeta) from "Capital Blue Cross" in Pennsylvania:
https://www.capbluecross.com/wps/wcm...df?MOD=AJPERES
I. POLICY
The use of pertuzumab may be considered medically necessary in the treatment of breast
cancer when all of the following conditions are met:
Patient has HER2–positive metastatic breast cancer
Pertuzumab is used in combination with trastuzumab and a taxane (e.g., docetaxel,
paclitaxel)
2. This is Blue Cross Blue Shield's position paper on Pertuzumab
https://www.bcbsnc.com/assets/servic...pertuzumab.pdf
Pertuzumab (Perjeta™) is a monoclonal antibody that is a HER2 receptor antagonist. It has received U.S.
Food and Drug Administration (FDA)-approval for use in combination with trastuzumab and docetaxel
for the treatment of HER2 positive, metastatic breast cancer. The combination of 2 HER2-active agents
targeting different subdomains of HER2 may result in a more comprehensive blockade of HER2 and its
pathways, and thus may lead to a greater treatment effect.
GOOD LUCK!
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