NHS reaches deal to roll out life-extending breast cancer drug after years of arguing over cost

Around a thousand women annually living with incurable metastatic breast cancer stand to benefit from the drug, which on average extends life by six months.

The approval was made possible by alterations to Nice's cost-effectiveness framework, introduced as part of a pharmaceutical partnership struck with President Trump's administration in April.

Charities hailed the decision as "a momentous day for thousands of people."

Nice had turned down Enhertu in 2024, ruling that metastatic breast cancer was insufficiently "severe" under its existing criteria to warrant the expense.

The rejection sparked an international controversy, given that the drug was already accessible in Scotland and 26 other European nations.

AstraZeneca's chief executive, Sir Pascal Soriot, publicly urged the NHS to overhaul its approach to funding medicines.

A breakthrough breast cancer treatment manufactured by AstraZeneca has been approved for use on the NHS in England

ASTRA ZENECA/REUTERS

The impasse began to shift after President Trump threatened to impose a 100 per cent tariff on pharmaceutical exports to the United States unless Britain increased its spending on drugs.

In response, Nice's cost-effectiveness thresholds were raised in April from £20,000-£30,000 per healthy year of life to £25,000-£35,000.

Negotiations resumed over the summer with AstraZeneca and its partner Daiichi Sankyo, culminating in a confidential pricing agreement.

Health Secretary Yvette Cooper described the drug as "life-changing," adding: "It is a tribute to the campaigners and charities who never stopped pressing for this, and it follows the changes this government has made to the Nice framework as part of the UK-US pharmaceutical partnership so more people can benefit from cutting-edge treatments."

Tom Keith-Roach, AstraZeneca's UK president, said: "Today's announcement marks a vital milestone for women in England living with HER2-low metastatic breast cancer.

It brings access into line with Scotland and 26 other European countries, offering renewed hope to more than a thousand women living with this particularly aggressive form of the disease."

Enhertu belongs to a category of medicines called antibody-drug conjugates.

Administered intravenously every three weeks, it targets cancer cells by binding to the HER-2 protein on their surface, then delivers chemotherapy directly to the tumour.

Although it costs more than £100,000 per year, the NHS secured a significant discount.

Claire Rowney of Breast Cancer Now said: "This is a momentous day for thousands of people who will now have access to a drug that will give them the opportunity to gain precious extra time with loved ones." She urged the government, Nice, NHS England and the pharmaceutical industry to reform what she called a "broken system" so patients with incurable cancer are never again forced to spend precious time campaigning for access to treatments.

Alison Jones, 63, from Worthing in West Sussex, who was diagnosed with metastatic breast cancer in January 2022, told the Times she was "over the moon," though her thoughts turned immediately to four fellow campaigners who died before the decision was reached.

Nice's director of medicines evaluation, Helen Knight, acknowledged the approval had come too late for many families, telling the publication: "I’m pleased that a commercial solution, alongside recent changes to Nice’s cost-effectiveness thresholds and the use of new methods for assessing quality of life, has meant this treatment can now be provided on the NHS.

"However, we know this decision comes too late for many families and our thoughts are with them today. Our role is important in ensuring NHS spending on new medicines reflects the benefits they deliver while protecting valuable health resources for other essential patient services."