Thousands of women with incurable breast cancer say they are being “robbed of precious time with their loved ones” after they were denied drugs available in Scotland to prolong their lives.
In what has been hailed as a “dark day” for patients, the National Institute for Health and Care Excellence watchdog said Enhertu is not profitable.
Trials of the drug found that it increased cancer control time from seven months to more than two years, results that experts called “mind-blowing.”
Charities and patients said they were “absolutely shocked” by the decision, which comes months after it was approved north of the border.
Called a “wonder drug” by oncologists, it is also available in 13 other European countries, as well as the United States and Canada.
Sophie Blake, 51, from Brighton, was diagnosed with breast cancer in December 2020 before being told it had spread to other places, including her lungs and liver, in May 2022.
Called a “wonder drug” by oncologists, Enhertu is also available in 13 other European countries, as well as the US and Canada.
Last night, health officials were accused of creating a “cruel postcode lottery” in which “women’s lives in England, Wales and Northern Ireland are somehow worth less”.
In a sign of growing anger, a Breast Cancer Now petition rallying against the decision had reached more than 6,000 signatures in just a few hours.
Baroness Delyth Morgan, chief executive of the charity, blamed a “broken system”, adding new methods to evaluate health technologies in Nice, for “denying patients with secondary breast cancer access to potentially life-prolonging medicines and which may have been pre-approved on the NHS.”
She said: ‘This is a dark day. This means thousands of mothers, daughters, sisters and wives are faced with the knowledge that there is a treatment that could have been a lifesaver for them, but remains out of reach.
“Meanwhile, women in Scotland have been allowed access to it.”
Speaking of NHS England, Nice and pharmaceutical giants Daiichi Sankyo and AstraZeneca, she added: “Everyone needs to come back to the table and find a solution that puts women first.”
Known as trastuzumab deruxtecan, it is the first targeted treatment authorized for patients with a type of cancer, known as HER2-low, that cannot be removed surgically or that has spread.
Around 1,000 women each year in England could benefit from the drug, which patients described as “the ultimate roll of the dice”.
Costing around £10,000 per patient per month in the US, it is understood the NHS offer was significantly cheaper, and less than that agreed with the Scottish Medicines Consortium.
The decision follows new NICE criteria, which give importance to drugs used for the most serious medical cases rather than previously focusing on end-of-life treatment.
He said there were uncertainties in the evidence that meant the most likely cost-effectiveness estimates were above the range that considers acceptable use of NHS resources.
Helen Knight, head of medicines assessment at NICE, said: “Despite taking into account the severity of the disease by applying a severity modifier and taking into account innovation and uncaptured benefits, the cost asking the NHS to pay was too high in relation to the benefits. she anticipates it being recommended for routine use in the NHS.’
But activists questioned how “terminal cancer can be downgraded” and accused officials of “betraying patients to save money.”
Sophie Blake, 51, from Brighton, was diagnosed with breast cancer in December 2020 before being told it had spread to other places, including her lungs and liver, in May 2022.
Although the former TV presenter’s cancer is currently under control, she said she “lives from scan to scan”, but this has left her with one last line of treatment when she needs it.
MS Blake, former TV presenter, said: “I feel like NICE, NHS England and the pharmaceutical companies are basically saying our lives are not valued and we are disposable.”
She said: “It feels like a massive betrayal of patients by the people we depend on to keep us alive to decide that people in England, Wales and Northern Ireland will not have access to this life-prolonging drug. life, but if you live in Scotland, you can do it.
‘It’s so cruel. They tell us that our lives are not worth this drug and they decide that our lives are not worth the money, that our families are not worth the years this could give us.’
He added: “I feel like NICE, NHS England and the pharmaceutical companies are basically saying our lives are not valued and we are disposable.” “It is absolutely disgraceful, a scandal and we will not give up the campaign to have this decision overturned.”
It comes weeks after a major study found that UK patients were less likely to receive chemotherapy and radiotherapy than other comparable countries, directly affecting their chances of survival.
The treatment lottery was particularly harsh among older patients, the Cancer Research UK-funded study found, effectively wiping years off people’s lives.
The NHS already recommends the use of Enhertu for other types of breast cancer in England through the Cancer Drugs Fund, which provides an avenue to trial new cancer drugs.
Checking your breasts should be part of your monthly routine so that you notice any unusual changes. Simply rub and feel up and down, feeling in semicircles and in a circular motion around the breast tissue to detect any abnormalities.
Breast cancer symptoms to look out for include lumps and swelling, dimpling of the skin, color changes, discharge, and a rash or crusting around the nipple.
But draft guidance published by Nice in September said it would not recommend its use in the NHS in England due to uncertainties in the information provided by the manufacturer.
Drugmakers suggested changes to the way NICE now assesses new medicines were being denied to patients on a “technicality”.
Haran Maheson, vice president of Daiichi Sankyo UK, said: “We are very disappointed that breast cancer patients in England and Wales will lose out due to a technicality in the new formula Nice uses to evaluate cancer drugs. “.
‘As we have shown in Scotland, it is possible to provide access to this medicine cost-effectively in the UK.
“Patients now face a ZIP code lottery.”
Tom Keith-Roach, president of AstraZeneca UK, added: “This is a devastating decision and one that is out of step with other countries, including Scotland.
“This is extremely uncomfortable and we ask Nice to reverse this decision.”
An NHS spokesperson said: “NHS England expected pharmaceutical companies AstraZeneca and Daiichi Sankyo to offer this treatment at a price that would allow NICE to recommend its use for the treatment of patients with secondary breast cancer in NHS England.
“We are therefore deeply disappointed that AstraZeneca and Daiichi Sankyo have not been willing to price this treatment to enable its approval, thereby denying NHS patients the opportunity to access this latest advance in care.”