Breast cancer drug Kadcyla now offered on NHS

By Dr. Ananya Mandal, MDJun 15 2017

In a major move, Kadcyla, a breast cancer drug that could prolong life expectancy and disease free survival among breast cancer patients is to be offered on NHS as a result of a deal between the health service and Pharmaceutical company Roche.

Kadcyla, is useful for patients with a special marker on their breast cancers which are thus called Her2/neu positive tumors. This drug has been studied to extend the life of terminally ill breast cancer patients by six months. Kadcyla or Traztuzumab emtansine, is useful in patients with HER2-positive tumors which have spread to other parts of the body from the breast and is now at a stage where operating it out is not possible. The drug is administered by an intravenous injection once every three weeks and has been seen to improve the quality of life for patients on it when compared to other treatments. It also causes less side effects in those comparisons.

This availability of the drug on NHS is said to be good news for around 1,200 women annually. According to NHS England chief executive Simon Stevens as a result of the “negotiation” and “flexibility” on the part of the stakeholders (the health service and the drug maker), patients and taxpayers would be getting a “good deal”.

In April this year, Scotland decided to offer this drug to patients in their health care service. It was still called “too expensive” by rest of UK. The National Institute for Health and Clinical Excellence (NICE), or the regulatory body went through the details of the cost effectiveness of this drug as claimed by the drug makers. The drug was not approved by the NICE in 2015 due to this high price.

Kadcyla cost undiscounted £90,000 per patient. According to experts the actual price of the drug is estimated to be £166,000 for every “quality adjusted life year” of good health. This takes into account not only the price of the drug but also the health impact of the drug on life extension of the terminally ill patients. Although the exact numbers regarding the present cost of the drug is not in yet, cost per quality adjusted life year has come down to £50,000. This is comparable to other drugs that are offered to terminally ill patients.

Up until now this drug was available for use in England via the £1.27bn Cancer Drugs Fund, an initiative of the UK government, started in 2010 that pays for drugs which are not routinely available on the NHS. In 2014 and 2015, 778 women could avail Kadcyla via this fund. However with the NICE suggesting that the drug was too expensive, the cost effectiveness of the drug came under scanner and the Fund would no longer be able to support the accessibility to this drug. This new move comes as a welcome relief there.

Richard Erwin, general manager at Roche said that the regulatory body NICE has also recommended Kadcyla now as a cost-effective treatment. He also cited flexibility as one of the keystones in bringing this change about. The Welsh government and Northern Ireland are also going to follow suit with this drug.

Breast cancer researchers and advocates have commended this move citing the fact that it will benefit many women. As per the reports from Cancer Research UK, there are 55,000 new cases of breast cancer annually and nearly 10,000 deaths occur from this dreaded cancer each year.