Acting on a HER2 Result and Navigating Access to Therapy

This episode follows the path from a positive HER2 result to a patient starting treatment. The panel describes framing an ERBB2 mutation for patients as a targetable driver and weighing oral versus intravenous options with the collaborating physician. Attention turns to the pharmacist, whose role increasingly begins before the prescription: building genomic pathways that map sequencing results to treatment pathways, flagging new alterations for a busy care team, and screening early for financial and transportation vulnerability. The faculty explain why intravenous agents are often easier to get approved than oral oncolytics, contrasting buy-and-bill under the medical benefit with real-time pharmacy benefit adjudication and limited distribution specialty pharmacies, and describe pharmacist-led appeals, payer-specific documentation, and standardized order sets. The episode closes on how the landscape has changed, as HER2-mutant disease, long treated with platinum-based chemotherapy with or without immunotherapy, now has both oral and intravenous targeted options.