Patients with certain forms of breast cancer will be able to get treatment with Roche’s Kadcyla through England’s Cancer Drugs Fund after all, following successful last-ditch negotiations between the pharma and NHS England.

Kadcyla (trastuzumab emtansine) was up for the chop as part of the latest CDF cull, which saw 23 of the more expensive therapies pulled from the list as officials continue to struggle with keeping its rocketing spend under control. 

But the move sparked uproar, particularly as Kadcyla is the first and only targeted chemotherapy available for secondary breast cancer. However, the treatment doesn’t come cheap, costing more than £90,000 per patient at its full list price.

Last week a campaign for Roche to lower the price of Kadcyla to secure its place on the CDF reached its peak, with a petition organised by Breast Cancer Now attracting more than 42,000 signatures, highlighting the strength of feeling over the drug’s proposed removal from the list.

Kadcyla is one of five therapies winning a reprieve for now; Avastin (bevacizumab) will continue to be available through the Fund but only to cervical cancer patients (no longer breast and bowel cancer patients), as will Pfizer’s leukaemia drug Bosulif (bosutinib), Johnson & Johnson’s leukaemia drug Imbruvica (ibrutinib) and Takeda’s lymphoma therapy Adcetris (brentuximab vedotin). 

“It’s encouraging to learn that Roche and NHS England have been able to come to a deal, but patients relying on other delisted drugs such as the breast cancer drug Avastin for future treatments will no doubt be devastated,” said Baroness Delyth Morgan, chief executive of the charity. 

A big problem that won’t go away

“There’s a bigger problem with our drug access and pricing system that will not go away,” she stressed. “Now we’re looking to the Prime Minister to show leadership on this issue. A better, more flexible system will benefit the pharmaceutical industry, healthcare professionals, and - most importantly of all - the patients whose lives depend on these treatments”.

Paul Workman, chief executive of The Institute of Cancer Research, London, said it’s “great news” that some drugs will remain available to patients through the Fund. “However, we now have a situation where some cancer drugs have been off, on, off and now back on the list of available drugs. It’s extremely confusing, and for people with cancer it’s also distressing, with such uncertainty about which drugs are going to be available for them”.

He also called for a “unified, long-term and sustainable system of drug evaluation, which puts innovation at its heart and makes a single judgement based on patient benefit and cost-effectiveness, rather than the present duplication in functions between NICE and NHS England”.