The National Institute for Health and Care Excellence (NICE) has published draft guidance stating that the breast cancer drug trastuzumab emtansine (also known as Kadcyla) will not be made routinely available through the NHS.
NICE had previously assessed the drug, manufactured by Roche, as being too expensive for the NHS to fund, with the latest guidance issued in 2015.
The new draft guidance continues that stance, though the drug will still be available in England through the Cancer Drugs Fund while NICE consults with a final decision expected in February.
At its full price the drug costs around £90,000 per patient. But NICE was looking at a scheme where the NHS would pay the full price for a patient for just over a year, with a discount on subsequent treatment.
NICE was reviewing its decision alongside new evidence that showed that patients taking the drug could extend the lives of eligible patients by up to 9 months.
NICE bases its decision on evidence of a drug’s clinical and cost effectiveness, and has decided at this stage that it does not work well enough to justify its high cost.
Professor Peter Johnson, Cancer Research UK’s chief clinician, said: “It’s disappointing that the price remains too high for NICE to recommend it for routine use on the NHS at this stage.”
The drug is licensed to treat breast cancer patients with a form of the disease known as HER2-positive breast cancer, after it has spread to other parts of the body.
It could also be offered to patients whose tumour cannot be surgically removed or has stopped responding to initial treatment.
NICE estimates that around 1,200 people would be eligible to receive the drug if it were to be recommended.
Professor Carole Longson, director of the centre for health technology evaluation at NICE, said that NICE tries to offer as much flexibility as possible when looking at treatments that can extend a patient’s life.
“But the reality is that the price of trastuzumab emtansine is currently too high in relation to the benefits it gives for it to be recommended for routine commissioning in the NHS, even taking into account the end of life criteria and the patient access scheme,” added Longson.
NICE will consider submissions to its consultation in February with the final recommendation for the drug to follow. Johnson added his “hope that NICE and the drug company can work out an agreement which allows the drug to be made available.”