There will no doubt be disappointment on final guidance from the National Institute for Health and Clinical Excellence this week rejecting the use of GlaxoSmithKline's Tyverb and Roche's Herceptin for a subset of patients with breast cancer on the National Health Service.

As expected, the cost regulator has turned down the use of the Tyverb (lapatinib) and Herceptin (trastuzumab) alongside hormone therapy to treat postmenopausal women with metastatic breast cancer that is hormone receptor and HER2 positive.

According to the Institute, there was not enough evidence to suggest the overall survival benefit justify the cost of these medicines, and so neither could be recommended for use by the NHS.

The incremental cost per QALY (quality-adjusted life year) was calculated to be more than £74,000 for Tyverb and £51,000 for Herceptin compared with either of the aromatase inhibitors anastrozole and letrozole alone, significantly overshooting the bounds of cost-effectiveness.