Enhertu NHS Access will give about 1,000 women a year with HER2-low breast cancer the opportunity to receive the drug through the NHS in England after a change in the treatment’s recommendation.
Health Secretary Yvette Cooper said Enhertu “can be life-changing” and welcomed the decision, saying NHS patients would finally be able to benefit from the treatment. She also paid tribute to campaigners and charities that continued to push for access.
The decision follows a long-running campaign over the availability of Enhertu for people with HER2-low metastatic breast cancer. Breast Cancer Now said campaigners’ persistence had eventually paid off, while also highlighting the number of people who had missed out on the drug and died during the period when access was unavailable.
Enhertu NHS Access Brings Hope to Patients
Claire Rowney, chief executive of Breast Cancer Now, said: “Today we can finally say we did it.” However, she said the charity could not celebrate the decision without remembering the “devastating cost of this delay”.
Kate Wills, 51, knows personally what the change means. She has HER2-low metastatic breast cancer, which has spread to her bones and lungs, but continues to lead a full life as a wife, mother and professional.
Kate said it had been “incredibly painful” knowing that Enhertu could potentially keep her alive for longer while she could not access it. Her social media posts show her enjoying family life, with medical appointments providing occasional reminders of her illness.
When Kate learned that Enhertu treatment would now be available through the NHS, she immediately began crying. She said: “I really can’t believe it. I’m so relieved, I’m overjoyed.”
“It’s so hard keeping hope when you have stage four cancer. This gives me enormous hope,” she added.
Kate’s children are in their teens and early 20s, and she has been focused on staying alive long enough for her youngest child to finish school. The new access decision has allowed her to think beyond that immediate goal.
She said she has now “dared to dream” that she could live long enough to see her children fall in love and get married. At the same time, she said her happiness was mixed with sadness for women she knew who did not receive the treatment in time.
NICE Recommendation Changes After Drug Review
One of those women was Jeannie Ambrose, who was 53 when she spoke to BBC News two years ago. At the time, she said she wanted to continue living and spending time with her family and friends rather than having to campaign for treatment.
Jeannie died in January this year. Kate said her friend would have been “thrilled but also angry at how long it’s taken and how rejected we’ve felt”.
The BBC understands that pharmaceutical companies Daiichi Sankyo and AstraZeneca have not substantially reduced the price of Enhertu since the drug was initially rejected.
Instead, the reversal by NICE is largely linked to changes connected with a trade agreement with the United States. Under the deal, the UK government agreed to spend 25% more on medicines.
New QALY Rules Help Change Enhertu Decision, Enhertu NHS Access
As part of the changes, NICE increased the amount the NHS can pay for each additional year of good-quality life provided by a medicine. The upper threshold for a Quality-Adjusted Life Year, or QALY, rose from £30,000 to £35,000.
NICE also introduced a different and more detailed method of assessing patients’ quality of life at the end of August. Together, the changes were enough to alter the assessment of Enhertu.
Patient campaigns for Enhertu and other medicines are also thought to have contributed to the wider pressure surrounding access to treatments.
Daiichi Sankyo and AstraZeneca welcomed the NICE decision. AstraZeneca called for “strong collaboration” across the healthcare system to achieve faster and more equitable access to medicines in the future.
Breast Cancer Now is calling on the government, NICE, NHS England and pharmaceutical companies to work together to change the system so people with incurable metastatic breast cancer do not have to spend valuable time campaigning for treatments.
Helen Knight, NICE’s director of medicines evaluation, said she was pleased that a “commercial solution” had made Enhertu available through the NHS in England. She also acknowledged that the decision had come too late for many families.
NICE said its role includes ensuring NHS spending on new medicines reflects their benefits while protecting resources for other essential healthcare services.
For Kate, the change represents a major shift after fearing she could die before receiving a treatment she believed could give her more time. “To know that I can get it now is absolutely everything,” she said.