NICE Rejects Enhertu for NHS Use Due to Pricing Stalemate with AstraZeneca and Daiichi Sankyo

NICE Decision:
The National Institute for Health and Care Excellence (NICE) has rejected the use of Enhertu (trastuzumab deruxtecan) for treating HER2-low secondary or unresectable breast cancer on the NHS in England due to a failure to agree on a cost-effective price with industry partners AstraZeneca and Daiichi Sankyo13.

Pricing Stalemate:
Despite negotiations, the companies did not offer a new price that NICE considered good value for money, leading to the final decision not to recommend the drug13.

Impact:
This decision affects approximately 1,000 people who could have benefited from Enhertu, a targeted treatment for HER2-low metastatic or unresectable breast cancer after chemotherapy13.

Severity Modifier Concerns:
The introduction of the severity modifier in NICE’s methods in 2022 has raised concerns that it may lead to other effective treatments for secondary breast cancer being rejected by NICE23.

Availability Elsewhere:
Enhertu is available in Scotland and on an interim basis in Northern Ireland, highlighting the disparity in access to this treatment across the UK2.

Potential Reversal:
NICE has indicated that a new decision could be reached within weeks if the industry partners are willing to drop their price to a level considered good value for money13.

Sources:

1. https://www.nationalhealthexecutive.com/articles/enhertu-breast-cancer-drug-rejected-nice-after-industry-talks-break-down-again

2. https://breastcancernow.org/about-us/media/statements/breast-cancer-now-respond-to-devastating-nice-decision-to-not-recommend-life-extending-breast-cancer-drug-enhertu-in-england/

3. https://www.nice.org.uk/news/articles/nice-disappointed-that-companies-unwilling-to-offer-fair-price-to-the-nhs-to-make-enhertu-available