This episode examines the barriers to accessing HER2-targeted therapies for non-small cell lung cancer (NSCLC) and strategies to overcome them. The discussion highlights the importance of aligning with payer requirements and clinical guidelines, such as those from NCCN, to facilitate insurance approval of recently FDA-approved HER2-targeted treatments.
This episode examines the barriers to accessing HER2-targeted therapies for non-small cell lung cancer (NSCLC) and strategies to overcome them. The discussion highlights the importance of aligning with payer requirements and clinical guidelines, such as those from NCCN, to facilitate insurance approval of recently FDA-approved HER2-targeted treatments. Panelists address practical challenges, including differences in the approval process for oral versus infusion therapies, the need for prior authorizations, and frequent initial insurance denials. They emphasize the crucial role of pharmacy teams, specialty pharmacies, and patient assistance programs in supporting patients through the approval process and helping to manage treatment costs. The conversation underscores the persistence sometimes required to secure coverage and the value of team-based approaches, including working with pharmacy liaisons and advocacy resources. Ultimately, practices are encouraged to become familiar with access pathways and available support mechanisms to ensure eligible patients receive timely and appropriate HER2-targeted therapies.
Rethinking Prior Authorization: Bridging Clinical Needs and Administrative Burdens
February 11th 2026This article highlights challenges in prior authorization and offers practical, experience-based strategies to streamline workflows, reduce delays, and improve patient access to necessary treatments.
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