A new orally administered targeted therapy for metastatic breast cancer that has spread to the brain is to be covered by the National Health Insurance (NHI) program, in an effort to substantially reduce patients’ medical costs, the NHI Administration (NHIA) said yesterday.
Lapatinib, sold as Tykerb, which costs NT$502 per tablet, will be covered by the NHI as of Monday.
Given that the recommended dosage of Tykerb for metastatic breast cancer is 1,250mg, or five tablets per day, the NHI including the drug in its coverage is expected to save each patient about NT$75,000 (US$2,500) a month, the administration said in a press release.
Chiu Chui-wen (邱垂文), a section chief at the NHIA’s Medical Review and Pharmaceutical Benefits Division, said the number of insured individuals opting for the new targeted medication is expected to be 34 in the first year and to rise to 108 in the fifth year.
The administration’s statistics show that breast cancer is the second-most common cancer among women in Taiwan.
Breast tumor cells can invade bones and other organs, particularly among those whose cancer tests positive for human epidermal growth factor receptor 2 (HER2), a protein that promotes the growth of cancer cells.
“Brain metastases are notoriously difficult to treat, but they occur in 15 to 25 percent of women with metastatic breast cancer,” Chiu said.
Chiu said while trastuzumab, sold as Herceptin — a targeted drug administered via injection that was included in the NHI program in 2002 — has been effective in treating patients with HER2-positive early stage breast cancer or those whose tumor cells have spread, it is unable to cross an intact blood-brain barrier because of its relatively large molecular size.
Tykerb, being a smaller molecule, can not only cross the barrier, but also lengthen users’ survival time by an additional 15.7 months, compared with four to six months for people who receive traditional chemotherapy, Chiu said.
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