Trastuzumab (Herceptin and biosimilars), Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta)

Aetna covers trastuzumab (Herceptin and biosimilars) and trastuzumab‑hyaluronidase (Herceptin Hylecta) for neoadjuvant, adjuvant, and recurrent/advanced/unresectable/metastatic HER2‑positive breast cancer (including brain mets) and intrathecal use for leptomeningeal disease, and for HER2‑amplified, RAS/BRAF wild‑type colorectal (including appendiceal/anal) cancer only in combination with pertuzumab or lapatinib when the member is not appropriate for intensive therapy or as subsequent therapy for progression. Aetna prefers Herzuma and Ogivri (requiring contraindication/intolerance/ineffective response to these biosimilars before approving higher‑cost trastuzumab brands) and considers other indications and the explicitly listed cancers — and trastuzumab+lapatinib or trastuzumab+pertuzumab for HER2‑positive breast cancer — experimental/investigational.

"C18."

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