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NICE relents on Kadcyla after Roche pricing negotiations

HER2-positive breast cancer therapy to be made available on the NHS in England

Roche Kadcyla

Roche’s HER2-positive breast cancer therapy Kadcyla will be made available on the NHS in England after the drug maker agreed a confidential access deal with cost-effectiveness watchdog NICE.

The agreement comes after years of wrangling between NICE and the pharma group over the price of Kadcyla (ado-trastuzumab emtansine), which has a list price of £90,000 a year but extends survival in women with advanced metastatic breast cancer by around six months.

Roche has offered an undisclosed price cut which means that around 1,200 women with incurable secondary breast cancer will now be eligible to receive Kadcyla in England each year.

Kadcyla has been made available to some patients through the Cancer Drugs Fund (CDF) since 2014, although Roche also had to cut its price in 2015 to keep the drug in that programme after it was listed among therapies heading for a cull. The new deal means it will move out of that system and be available for NHS funding later this summer, said NICE in a statement.

Aside from the price reduction, NICE said it had also taken into account its advisory committee’s decision that it was appropriate to compare Kadcyla with the combination of Roche’s older HER2-targeting drug Herceptin (trastuzumab) with capecitabine that has latterly become the standard treatment for advanced HER2-positive breast cancer. Previously, Kadcyla had been compared in NICE’s deliberations to other therapies.

The agreement has been welcomed by charity Breast Cancer Now, which has been pushing hard for a price cut on the drug for years. Kadcyla gives ‘significant and precious extra time’ to women with incurable secondary breast cancer, as well as having fewer side effects that allow them to spend more quality time with their loved ones.

“This is exceptionally good news for so many breast cancer patients,” said the charity’s chief executive Baroness Delyth Morgan.

“We are absolutely delighted that tough negotiation and flexibility by NICE and NHS England, and the willingness of Roche to compromise on price, have ensured that thousands of women with incurable breast cancer will be given precious time to live.”

Breast Cancer Now delivered a warning about another Roche HER2 drug – Perjeta (pertuzumab) – which it said was at risk of being removed from NHS use as a first-line treatment for this group of patients.

“Perjeta’s benefits are extraordinary, offering nearly 16 additional months of life to women with incurable breast cancer, and it is imperative that a solution is found to save this drug, at a cost affordable to both the NHS and the taxpayer,” said Morgan.

Phil Taylor
16th June 2017
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