Key facts
- Enhertu will be available on the NHS in England for approximately 1,000 women per year with HER2-low advanced breast cancer.
- The drug can extend life by an average of seven months, with some patients living up to three years longer.
- NICE previously rejected Enhertu in July 2024, deeming it not cost-effective.
- A trade deal with the US, involving increased spending on medicines, influenced changes to NICE's evaluation framework.
- The upper threshold for NHS spending per Quality-Adjusted Life Year (QALY) has increased from £30,000 to £35,000.
- Enhertu is a targeted treatment that delivers chemotherapy directly to cancer cells.
Thousands of women in England with HER2-low advanced breast cancer can now access the life-extending drug Enhertu on the NHS, following a price deal and changes to the National Institute for Health and Care Excellence (NICE) evaluation framework. The drug, which can give patients an average of seven extra months to live, was previously deemed too expensive by NICE in July 2024.
The decision comes after a trade deal with the US, which led to an increase in the upper threshold for NHS spending per Quality-Adjusted Life Year (QALY) from £30,000 to £35,000. NICE also introduced a more nuanced way of measuring patient quality of life. These changes, along with persistent campaigning by charities and patients, were instrumental in reversing the earlier rejection.
Health Secretary Yvette Cooper stated that Enhertu is "life-changing" and that the recommendation will allow NHS patients to benefit. Breast Cancer Now, a charity that campaigned for access, noted that while the decision is a victory, many have missed out and died due to the delay. Kate Wills, a patient with HER2-low metastatic breast cancer, shared her emotional relief, expressing hope for the future while remembering friends who did not live to see this day.
Enhertu is a targeted treatment developed by Daiichi Sankyo and AstraZeneca that delivers chemotherapy directly to cancer cells. While the drug companies have not substantially lowered their prices, the revised NICE framework has made it cost-effective for the NHS. Wales is expected to follow England in making the drug available, though the guidance does not automatically apply to Northern Ireland.