The_Guardian_-_2016-12-29

“Kadcyla can give people [on average] nine months longer to be there for the moments that matter –
the first day at school, a wedding, a family birthday – with far fewer enduring severe side-effects like
sickness and diarrhoea than with many other drugs,” Breast Cancer Care said.
Nice, which evaluates drugs for use in the NHS in England, originally turned down Kadcyla, but
patients were able to get it anyway via the cancer drugs fund, a pot of money put aside for such
circumstances by the coalition government.
However, the CDF massively overspent and is now under the control of Nice, which is re-examining
the value for money of all the drugs it has been paying for.
Nice has now said in draft guidance that the price is too high even after a discount offered by Roche.
The company had offered to foot the bill for any patients who needed to stay on the drug beyond 14
months.
About 1,200 patients could benefit from Kadcyla if it were to be funded by the NHS in England.
Roche submitted data to Nice to show that the drug could give women on average nine months longer
than the standard treatment currently available – a considerable amount of extra time for women
suffering from a particularly aggressive type of breast cancer, Her2+, which often affects younger
women.
Nice said it was not a final decision. It will be hoping that Roche brings down the price. However, it
has not done so in Scotland, where the cancer drugs fund does not apply and women can only get
Kadcyla in exceptional circumstances.
Breast cancer charities will campaign against the draft Nice decision in the hope of bringing about a
U-turn when the assessment committee meets to make its final decision in February. The Breast
Cancer Now petition calls on Sir Andrew Dillon, the chief executive of Nice, and Richard Erwin,
general manager at Roche Products, to urgently return to the negotiating table.
Delyth Morgan, the chief executive of Breast Cancer Now, said: “This disastrous decision is a huge
setback for the treatment of advanced breast cancer. Kadcyla offers significant and precious extra
time for women with incurable cancer in great need of hope, and we mustn’t let it slip away.
“Nice and Roche’s inability to find a compromise is seeing secondary breast cancer patients left
abandoned. Responsibility lies on both sides, and such reckless brinkmanship is unfortunately about
to rip away one of the best breast cancer drugs in years from patients in desperate need of a lifeline.”
The charity argued that Nice had not compared Kadcyla with the appropriate alternative treatment
when making its calculations of cost-effectiveness. “This outcome also speaks volumes about a drug
appraisal system that is just not working for metastatic breast cancer patients. This targeted drug is
available in many other countries, including France, Germany, Australia and Canada, and it is
nowhere near good enough that women in England will be denied such an effective option,” Lady
Morgan said.
Danni Manzi, of Breast Cancer Care, said: “While we understand the pressure around budgets, it is