Clinical Pharmacist Readiness in Trastuzumab Therapy Management for Her2-Positive Breast Cancer Patients: Perspectives on Therapeutic Monitoring, Drug Accessibility, and Economic Challenges
Keywords:
clinical pharmacist readiness, drug accessibility, economic challenges, her2-positive breast cancer, trastuzumab therapyAbstract
Breast cancer with human epidermal growth factor receptor 2 positivity requires complex treatment management due to the need for continuous therapeutic monitoring, sustained medication access, and the high economic burden associated with targeted therapy. Clinical pharmacists play an important role in supporting treatment effectiveness, patient safety, and continuity of care. This study aimed to assess clinical pharmacist readiness in trastuzumab therapy management for patients with human epidermal growth factor receptor 2-positive breast cancer, focusing on therapeutic monitoring, drug accessibility, and economic challenges. A quantitative cross-sectional survey was conducted among 150 pharmacists involved in oncology services who were recruited using purposive sampling. Data were collected using a structured online questionnaire and analyzed using descriptive and correlational statistics. The findings showed that overall pharmacist readiness was high. Therapeutic monitoring readiness achieved the highest score, indicating strong confidence in monitoring treatment outcomes and managing medication-related issues. Drug accessibility readiness and economic challenge readiness demonstrated comparatively lower scores, reflecting ongoing concerns regarding medication availability, reimbursement processes, affordability, and healthcare financing. Positive correlations were observed among all readiness domains, suggesting that clinical, accessibility, and economic competencies are closely interconnected. The study concludes that pharmacists are generally well prepared to support trastuzumab therapy management; however, strengthening competencies related to medication access and economic evaluation remains essential to optimize oncology pharmacy services and improve the sustainability of cancer care.
References
Ahmed, R., & Tamim, T. R. (2025). Enhancing medication safety: the role of community and hospital pharmacists in modern healthcare systems. Radinka Journal of Health Science, 2(3), 328–355.
Barrios, C., de Lima Lopes, G., Yusof, M. M., Rubagumya, F., Rutkowski, P., & Sengar, M. (2023). Barriers in access to oncology drugs—a global crisis. Nature Reviews Clinical Oncology, 20(1), 7–15.
Farina, K. A., & Rattu, M. A. (2022). Pharmacist involvement in antibody-drug conjugate therapy. US Pharm, 47(1), 34–42.
Gupta, R., Gupta, S., Antonios, B., Ghimire, B., Jindal, V., Deol, J., Gaikazian, S., Huben, M., Anderson, J., & Stender, M. (2022). Therapeutic landscape of advanced HER2-positive breast cancer in 2022. Medical Oncology, 39(12), 258.
Hubar, M., & Sholoiko, N. (2025). Pharmaceutical provision as a complex work of pharmacy stakeholders. The Ukrainian Scientific Medical Youth Journal, 154(2), 173–182.
Iloabanafo, C. A., Hamzat, S. A., Igbin, L. A., & Oluwakemi, A.-K. H. (2025). The Role Of Pharmacists In Enhancing Medication Safety Through Community Outreach In Developing Countries. CogNexus, 1(03), 123–137.
Keller, M. S., & Carrascoza-Bolanos, J. (2023). Pharmacists, nurses, and physicians’ perspectives and use of formal and informal interpreters during medication management in the inpatient setting. Patient Education and Counseling, 108, 107607.
Mansour, R., Abdel-Razeq, H., Al-Hussaini, M., Shamieh, O., Al-Ibraheem, A., Al-Omari, A., & Mansour, A. H. (2024). Systemic barriers to optimal cancer care in resource-limited countries: Jordanian healthcare as an example. Cancers, 16(6), 1117.
Marra, A., Chandarlapaty, S., & Modi, S. (2024). Management of patients with advanced-stage HER2-positive breast cancer: current evidence and future perspectives. Nature Reviews Clinical Oncology, 21(3), 185–202.
Mroczek, D. K., Hauner, K., Greene, G. J., Kaiser, K., Peipert, J. D., Golf, M., Kircher, S., Shaunfield, S., Lylerohr, M., & Cella, D. (2024). Obstacles to biosimilar acceptance and uptake in oncology: a review. JAMA Oncology, 10(7), 966–972.
Pei, Y., Huang, R., Chang, F., Hu, Y., Versteeg, S., & Zheng, Y. (2025). The role of pharmacists in delivering pharmaceutical services to breast cancer patients in clinical and community settings: a scoping review. Pharmacy, 13(4), 97.
Pharmacy, A. C. of C. (2023). Standards of practice for clinical pharmacists. Journal of the American College of Clinical Pharmacy, 6(10), 1156–1159.
Pirolli, A. V, Brusamarello, T., Everton, S. S., & Andrzejevski, V. M. S. (2022). The role of the clinical pharmacist in guiding adjuvant hormonal therapy in patients with breast cancer. Journal of Oncology Pharmacy Practice, 28(6), 1368–1374.
Sathyan, A., Mohanapriya, M., Madhanraja, R., Indu Vadana, K. S., Indhuja, K., Sumathi, P., & Varshini, G. (2025). A Comprehensive Review of Evidence and Challenges in Switching from Originator Drugs to Biosimilars of Monoclonal Antibodies: Focus on Rituximab and Trastuzumab. Journal of Drug Delivery & Therapeutics, 15(2).
Staynova, R., Gavazova, E., & Kafalova, D. (2024). Clinical pharmacist-led interventions for improving breast cancer management—a scoping review. Current Oncology, 31(8), 4178–4191.
SULASHVILI, N., BEGLARYAN, M., GORGASLIDZE, N., KOCHARYAN, S., CHICHOYAN, N., GABUNIA, L., ZARNADZE, I., KVIZHINADZE, N., PKHALADZE, G., & GIORGOBIANI, M. (2023). The disclosure of features, characteristics, possibilities and specialties of clinical pharmacists as mediator among doctors and patients for enhancement public health sector in a global world. Experimental and Clinical Medicine Georgia, 4, 57–62.
Umeano, A. (2023). Pharmacy-led clinical management models enhancing chronic disease care coordination within nursing practice across diverse healthcare delivery settings. Magna Scientia Advanced Biology and Pharmacy, 10(2), 111–130.
Umeh, A. U., Chima, U. E., Agbo, C. E., Chiekwe, O. S., Eze, A. E., Nwachuya, C. A., Mmuo, S. S., Nnedu, C. E., & Isah, A. (2025). Pharmacist-led medication therapy management: impact on healthcare utilization and costs. American Journal of Pharmacotherapy and Pharmaceutical Sciences, 4.
Unnissa, Z., Mudassir, M., Ali, S. E., & Hussain, M. M. (2025). Evolving role of clinical pharmacists in modern health care. International Journal of Basic & Clinical Pharmacology, 14(4), 623–630.
Vogenberg, F. R., & Marcoux, R. (n.d.). Pharmacy Practice, Managed Care, and Manufacturers. In O’Donnell’s Drug Injury (pp. 543–573). CRC Press.
Wang, J., & Wu, S.-G. (2023). Breast cancer: an overview of current therapeutic strategies, challenge, and perspectives. Breast Cancer: Targets and Therapy, 721–730.
Yoon, J., & Oh, D.-Y. (2024). HER2-targeted therapies beyond breast cancer—an update. Nature Reviews Clinical Oncology, 21(9), 675–700.
Zacholski, E. H., Dierckes, J., Hartnett‐Quach, D., Noda, C., Sharps, A., White, O., Zacholski, K., & Griffin, S. P. (2025). Comprehensive Framework for Oncology Pharmacist‐Led Parenteral Anticancer Therapy Patient Education: The Opinion of the American College of Clinical Pharmacy Hematology/Oncology Practice and Research Network. Journal of the American College of Clinical Pharmacy, 8(11), 1202–1214.
Zhang, G., Ren, C., Li, C., Wang, Y., Chen, B., Wen, L., Jia, M., Li, K., Mok, H., & Cao, L. (2022). Distinct clinical and somatic mutational features of breast tumors with high-, low-, or non-expressing human epidermal growth factor receptor 2 status. BMC Medicine, 20(1), 142.
