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Paleno PMS

Patient Number

  1. The patient who received on PALENO was, *

  2. Patient has received prior chemotherapy for metastatic disease, before starting PALENO? *

  3. The patient who received PALENO in HR+ve HER2 -ve MBC, is *

  4. What was the recommended dose of PALENO for this patient? *

  5. The patient who received PALENO is of________ which type? *

  6. Was there another hormonal therapy prescribed along with PALENO? *

  7. If YES, please tick the co-prescribed hormonal therapy

  8. Was there any dose modification of PALENO required in this patient? *

  9. Did you recommend the patient to enroll into the PAL 3600 Care program, an exclusive patient support program for PALENO? *

  10. In PAL 3600 Care program, patients buy PALENO only for 12 months. Post that it is given free for lifetime. According to you, how useful this PAP is__ *

  11. The patient category was___ *