Key Takeaways:
- NHS England will fund Enhertu breast cancer treatment for 1,000 women annually with HER2-low advanced breast cancer.
- The deal reverses a 2024 cost rejection, leveraging a raised £35,000 cost-effectiveness threshold.
- Clinical trials show Enhertu extends median overall survival by 6.6 months compared to chemotherapy.
About 1,000 women a year in England with incurable HER2-low advanced breast cancer will receive Enhertu on the NHS after a new price agreement, following a 2024 rejection over cost.
NHS Reverses Earlier Decision On Enhertu
The National Institute for Health and Care Excellence, which advises the NHS on treatment funding, recommends Enhertu breast cancer treatment for routine use in England. Eligible patients can receive the drug from Thursday under the new arrangement.
NICE rejected the treatment in July 2024, saying its cost was too high to represent an acceptable use of NHS resources. The decision followed evidence showing that Enhertu, also known as trastuzumab deruxtecan, could extend survival for people with HER2-low metastatic or unresectable breast cancer.
NICE, NHS England, AstraZeneca and Daiichi Sankyo later resumed negotiations and reached what NICE described as a “commercial solution.” The agreement allows the treatment to become available in England for the first time.
Clinical Trials Show Longer Survival
Clinical trial results show that Enhertu nearly doubles the median time before the disease worsens, compared with standard chemotherapy. Median progression-free survival increased from 5.1 months with chemotherapy to 9.9 months with Enhertu.
The treatment also increased median overall survival from 16.8 months to 23.4 months, a difference of 6.6 months. NICE previously acknowledged evidence that Enhertu breast cancer treatment increased both survival and the time before cancer progressed.
Dr. Catherine Elliott, Cancer Research UK’s director of research, said Enhertu is a targeted treatment that delivers chemotherapy directly to cancer cells. She said trial results show that it can help eligible patients live longer and delay disease progression.
Dr. Anne Rigg, a consultant medical oncologist and NHS England’s national specialty adviser for chemotherapy, called the decision “hugely positive news” for women with secondary breast cancer. She said patients will now receive the life-extending treatment through the NHS.
Price Rules Open Access In England
The decision follows changes to NICE’s cost-effectiveness framework. In April, NICE gained the ability to recommend NHS treatments costing up to £35,000 a year per patient, up from the previous £30,000 threshold.
It remains unclear whether AstraZeneca and Daiichi Sankyo reduced their requested price as part of the agreement. The Enhertu breast cancer treatment will cost NICE more than it was previously prepared to pay.
The drug has been available in Scotland since December 2023 and is used in 27 European countries. Health Secretary Yvette Cooper said the recommendation means NHS patients will be able to benefit from the treatment and credited campaigners and charities for continuing to press for access.
Wales and Northern Ireland are expected to consider implementing the recommendation. Breast Cancer Now chief executive Claire Rowney said the decision follows two years of campaigning by the charity, cancer specialists and women affected by the disease.
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