Life-Extending Breast Cancer Drug to Be Available on NHS in England

Around 1,000 women a year with incurable breast cancer are set to gain access to a life-extending treatment on the NHS in England after a previous decision not to routinely fund the drug was reversed.

The National Institute for Health and Care Excellence has recommended Enhertu, also known as trastuzumab deruxtecan, for people with HER2-low advanced or metastatic breast cancer whose disease has progressed following previous treatment.

The targeted treatment is designed for cancers with low levels of the HER2 protein that cannot be removed through surgery or have spread to other parts of the body.

Clinical trial evidence showed that Enhertu almost doubled the median length of time patients lived without their cancer progressing compared with chemotherapy, from 5.1 months to 9.9 months. Median overall survival was 23.4 months for those receiving Enhertu compared with 16.8 months for those receiving chemotherapy.

The decision marks a significant change for patients in England. NICE previously rejected routine NHS use of the treatment in 2024 after concluding that it was not cost-effective, despite evidence showing that it could extend people’s lives.

A new commercial agreement has now been reached with manufacturers Daiichi Sankyo and AstraZeneca. Changes to NICE’s assessment methods, including its cost-effectiveness thresholds and approach to assessing quality of life, also contributed to the treatment becoming available.

Enhertu has already been available to eligible patients in Scotland for more than two years, and the difference in access across the UK had become the focus of a major campaign by patients and breast cancer charities.

Breast Cancer Now described the decision as a significant victory after more than two years of campaigning, while also highlighting the women who died during the period in which the treatment remained unavailable through the NHS in England.

Enhertu does not cure advanced breast cancer, but for eligible patients it can slow the progression of the disease and provide additional time before their cancer worsens.

The treatment is available to eligible NHS patients in England from 17 September, bringing to an end a lengthy dispute over access to one of the newer targeted treatments for advanced breast cancer.

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