Breast Cancer | Access and Reimbursement | EU5 | 2017

The large size of the HER2-positive breast cancer market in Europe, driven by high incidence and long treatment duration with expensive agents, is of great commercial interest to drug developers. Premium-priced and highly effective agents including Roche’s Herceptin, Perjeta, and Kadcyla, have revolutionized the treatment algorithms for this indication, but costly agents are set to join them. With escalating drug costs and increasingly tight healthcare budgets, convincing EU5 payers of cost-effectiveness is crucial for reimbursement, while maximizing uptake thereafter is a huge tactical challenge. This research analyzes the treatment landscape and market access environment for HER2-positive breast cancer across the EU5.

Questions Answered in This Report:

  • What role do key brands like Herceptin, Perjeta, and Kadcyla play in HER2-positive breast cancer treatment in the EU5? What are their prescribing patterns in different treatment settings?
  • What clinical and cost-related factors most strongly influence and restrict prescribing across lines of treatment? How do these differ across the EU5?
  • How do physicians and payers view late-stage emerging agents for HER2-positive breast cancer, such as margetuximab (MacroGenics) and neratinib (Puma Biotechnology)? How might prescribing change following market entry of such agents, and what will be the impact of payer policy upon this?
  • How will the entry of biosimilar trastuzumab affect prescribing of Herceptin? How will national, regional, and local payers promote and monitor biosimilar prescribing?


  • Markets covered: France, Germany, Italy, Spain, United Kingdom.
  • Methodology: Survey of 252 medical oncologists and 10 country-specific interviews with European payers.
  • Indication coverage: HER2-positive breast cancer.
  • Key drugs covered: Herceptin IV and SC, Perjeta, Kadcyla, Tyverb, neratinib, margetuximab.
  • Key companies mentioned: Roche, Novartis, Puma Biotechnology, MacroGenics.
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