Patients in England with HER2-low metastatic breast cancer can now access Enhertu through the NHS, marking a reversal of a 2024 decision by the National Institute for Health and Care Excellence that deemed the medication too expensive for the health service. The drug has demonstrated the ability to extend survival by almost seven months on average, with some patients experiencing substantially longer lifespans. Scotland began providing the treatment through its NHS in 2023, and it remains available across 26 European nations.
The approval affects approximately 1,000 women annually diagnosed with this specific breast cancer subtype. Patient advocacy groups and charities have campaigned for broader access since the initial rejection, with Health Secretary Yvette Cooper acknowledging the efforts of campaigners in enabling this reversal. The change takes effect from Thursday, with Wales expected to follow shortly, and doctors in Northern Ireland can already prescribe it pending formal endorsement.
NICE’s decision to reverse its position resulted from two primary factors: modifications to how the organization measures treatment value following a United States trade agreement, and adjustments to quality-of-life assessment metrics introduced in late August. The threshold for cost per Quality-Adjusted Life Year increased from £30,000 to £35,000 under the trade arrangement. Drug manufacturers Daiichi Sankyo and AstraZeneca did not substantially reduce prices between the initial rejection and current approval.
Advocates for the medication acknowledge the bittersweet nature of the announcement. Breast Cancer Now’s leadership noted that while the decision represents success for ongoing campaigns, thousands of patients previously lacked access and many have since died. Patient testimonies underscore the emotional weight of the delay, with individuals expressing both relief and sorrow for those who did not survive to benefit from the treatment’s availability.
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