NICE says no to Roche breast cancer drug over high price

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The National Institute for Health and Care Excellence has published final draft guidance saying Roche’s targeted breast cancer drug Kadcyla is still too expensive to be available across the NHS in England and Wales.

Kadcyla (trastuzumab-emtansine) is the first and only targeted chemotherapy for secondary HER2-positive breast cancer and its list price is around £90,000 per course. Although  Roche has offered a discount, NICE says the company did not reduce the price enough to make it cost-effective for the NHS.

Sir Andrew Dillon, NICE’s chief executive, said: “We recognise that Kadcyla has a place in treating some patients with advanced breast cancer and we have been as flexible as we can in making our recommendation. However, the price that the manufacturer is asking the NHS to pay in the long-term is too high”.

Bigger discount on CDF

Patients in England will still be able to access Kadcyla in England through the country’s Cancer Drugs Fund, after a price cut offered by Roche, a bigger one than offered to NICE.  However patients in Wales and Scotland will be now be barred from treatment.

Roche responded by saying that its priority is ensuring that patients in the UK can benefit from innovative, life-changing medicines that are standard of care across Europe. It added that NICE’s guidance on Kadcyla “highlights the confusion at the heart of our drug access system and destroys patients’ faith in the system that is supposed to ensure they have access to the treatments they need”.

Roche added that “we need a unified approach and, moving forward, it is imperative that we work together to build a pragmatic, flexible and sustainable system for assessing medicines that prioritises clinical value. Only then will we be able to ensure the best outcomes for people with cancer in the UK”.

Patients are hugely disappointed, unsurprisingly. Caitlin Barrand, assistant director of Policy & Campaigns at UK charity Breast Cancer Now, said that “we simply cannot continue in this way, with highly effective new cancer drugs being held just out of reach for patients in certain areas of the UK”.

She added that “it’s time that the Prime Minister showed real leadership on this issue…a fairer, more flexible system that enables access to the best treatments available on a routine, UK-wide basis is long overdue”.