12.08.2014

Kadcyla Can Extend The Lives Of Sufferers By Up To Six Months

A drug that can extend the lives of some women suffering with an advanced form of breast cancer will not be made available of the NHS as it has been deemed too expensive.

According to the National Institute for Health and Care Excellence (Nice), the price of Kadcyla means it would be “impossible” to recommend its use across the health service. Final draft guidance from the organisation indicates that the drug will cost around £90,000 per patient at its full price.

The drug, which is also known as trastuzumab emstansine, can be used to treat breast cancer patients with HER2-positive breast cancer that has spread to other parts of the body. Around a fifth of breast cancer cases are HER2-positive and it is reported that the drug could benefit 1,500 women each year.

In many cases it is seen as a last hope, as it is used when the cancer cannot be surgically removed, and can extend the lives of patients by around six months. The way the drug acts means it is unlikely to cause patients the side effect of hair loss experienced with many other cancer treatments.

Kadcyla manufacturer Roche has said it has offered the drug at a reduced price to the NHS and will appeal the decision made by Nice. The company has criticised the role of Nice in the process and claims it has denied access to eight medicines for women with advanced breast cancer in the UK in recent years.

Nice chief executive Sir Andrew Dillon said that although Roche offered a discount, the price still prevented the recommendation of widespread use within the NHS. He said the discount still left the price of the drug “well above the top of our specially extended range of cost effectiveness for cancer drugs”.

Trastuzumab emstansine is currently available in England through the Cancer Drugs Fund, but doctors are required to make special requests to access the treatment for their patients and are not able to offer it to them immediately and in some cases not at all. Since April more than 200 women have used this system to access Kadcyla, but the Cancer Drugs Fund is due to end in 2016.

Breast cancer support groups and charities have urged Roche and Nice to continue their negotiations and make the drug available to women with advanced breast cancer.

Expert Opinion

This decision illustrates the often difficult decisions that need to be made in relation to the availability of drugs. Nice undoubtedly carries out a vital, complex and unique role in the process, but it is of course vital to ensure that patients are able to access the medication they need. <br/> <br/>“If they cannot, they have the ability to challenge their NHS trust to get access to many vital drugs and health treatments that are not widely available. <br/> <br/>“We’ve been involved in a number of cases in the past related to this issue, including helping women who sought access to the breast cancer drug Herceptin. In the case of these particularly difficult funding decisions it is all the more important that the correct decision making processes are followed and patients receive the treatment where their NHS treating clinician prescribes it.” Yogi Amin - Partner