The advanced breast cancer treatment trastuzumab emtansine (marketed by Roche as Kadcyla) will not be available through normal funding routes on the NHS in England, final guidance from the UK National Institute for Health and Care Excellence has said.
The drug has been licensed to treat HER2 positive metastatic breast cancer that has stopped responding to initial treatment. It is capable of extending the life of patients with advanced breast cancer by six months, but the cost of £90 000 (€130 000; $140 000) for an average course of treatment (14.5 months) gives trastuzumab a cost per quality adjusted life year (QALY) of £166 000, well above the normal threshold for drugs used at the end of life of around £50 000 per QALY.
In October trastuzumab emtansine was one of five drugs that were reinstated to the list of drugs paid for by England’s Cancer Drugs Fund after a discount from Roche, although the size of the price reduction was not disclosed.2 This meant that women in England will continue to have access to the drug until April next year, when a new cancer drugs fund is due to be launched.
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