Brigatinib
Brigatinib is an ALK pill with strong brain activity, approved first after crizotinib and then first line after beating it in ALTA-1L.
ALTA (2017, after crizotinib) and ALTA-1L (2018-20: PFS 24 vs 11 months versus crizotinib, intracranial response 78%). Early pulmonary events in the first week require a 90 mg lead-in. Competes with alectinib and lorlatinib first line.
- Medicare
- Part D (self-administered)
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026).
- Commercial insurance
- covered with prior authorisation
Covered for FDA-labelled and NCCN-listed uses, but almost always behind prior authorisation confirming diagnosis, biomarker and line of therapy; dispensed through a specialty pharmacy.
- Assistance programmes
- Takeda Oncology Here2Assist
- PAN Foundation — Disease-specific co-pay and premium funds; open and closed funds change monthly.
- HealthWell Foundation
- CancerCare Co-Payment Assistance Foundation
- Patient Advocate Foundation Co-Pay Relief
Part D out-of-pocket capped at $2,000 (2025) / $2,100 (2026). Medicare patients cannot use manufacturer co-pay cards; charity funds (PAN, HealthWell, CancerCare) and the Extra Help subsidy are the routes.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
- Appraised for
- Untreated ALK-positive advanced NSCLC
- Notes
- After crizotinib: TA571 (2019).
- NHS England
- Routinely funded for the appraised indication (or via managed access)
Sources: NICE TA670 · SMC advice: brigatinib. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2017 | ALK-positive metastatic NSCLC after crizotinib |
| US | 2020 | First-line ALK-positive metastatic NSCLC |
| EU | 2018 | ALK-positive NSCLC |
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Latest papers
topQuery for this drug: (TITLE:"Brigatinib" OR ABSTRACT:"Brigatinib" OR TITLE:"Alunbrig" OR ABSTRACT:"Alunbrig") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Brigatinib, not a curated reading list.
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