‘Lives will be cut short’ by ruling to reject breast cancer drug in England
THOUSANDS of lives will be cut short after a drug that can offer patients with incurable breast cancer precious extra time was rejected for NHS use, a charity has warned.
Enhertu recognises the HER2 hormone on the surface of tumours and delivers a targeted dose of chemotherapy. It is already available on the NHS to treat some types of breast cancer.
However, the National Institute for Health and Care Excellence decided it was not cost effective for patients with low levels of HER2 whose cancer has spread or cannot be removed by surgery. Had the drug been approved, around 1,000 more women would have been eligible in England. A row erupted as NHS chiefs blamed the manufacturers for failing to drop the price, while the pharma firms argued the assessment had not fully considered the benefits.
The decision marked “a dark day”, said Breast Cancer Now. It said the UK faced a “heartbreaking postcode lottery of access”, as Enhertu has been approved in Scotland. The rejection is expected to hit patients in Wales and Northern Ireland as those nations often follow Nice decisions.
The charity’s Baroness Delyth Morgan said: “NHS England, Nice, Daiichi Sankyo [a drugs firm] and AstraZeneca have failed people living with the disease. They’ve blocked a vital treatment that offers hope of more time for thousands of people with a certain type of secondary breast cancer.
“Mums, daughters, sisters, wives, colleagues, and friends who want to create special memories, now face the unbearable reality of knowing a treatment that could have been a lifeline for them exists.
Devastating
“But it remains out of reach, while women in Scotland have been granted access.” Baroness Morgan urged all parties to strike a deal. Enhertu has a list price of £117,858 per course but is offered to the NHS at a confidential discount. An NHS England spokesman said: “We are deeply disappointed that AstraZeneca and Daiichi Sankyo have not been willing to price this treatment to enable approval.”
However, the drug companies claimed a change to Nice’s appraisal methods meant the benefits of the drug for end-of-life care were not fully taken into account.
A trial found patients with low levels of HER2 who took the drug after chemo survived an average six months longer than those who did not. Tom Keith-Roach, of AstraZeneca UK, said: “This is a devastating decision which is out of step with other countries. We call on Nice to reverse this decision” Haran Maheson, of Daiichi Sankyo UK, added: “We are extremely disappointed that patients are going to lose out due to a technicality in the new formula Nice uses.”
Helen Knight, of Nice, acknowledged the treatment was a significant development. But she added: “The cost the NHS was being asked to pay was too high in relation to the benefits it provides for it to be recommended for routine use.”