Patients in England with a particular type of incurable breast cancer can now be prescribed a life-extending drug on the NHS, two years after the country’s cost watchdog said it was too expensive. The drug, Enhertu, made by Daiichi Sankyo and AstraZeneca, became available to doctors in England on Thursday 17 September, the BBC reported. Wales is expected to follow shortly, and doctors in Northern Ireland can already prescribe it ahead of the formal endorsement process.
Who can get it
The National Institute for Health and Care Excellence (NICE) recommends Enhertu (the generic name is trastuzumab deruxtecan) for adults with HER2-low advanced or metastatic breast cancer whose disease has progressed following treatment. HER2 is a protein found on the surface of some breast cancer cells. Tumours with low levels of it, called HER2-low, were historically treated in the same way as HER2-negative cancers, so this group had fewer targeted options.
NICE says around 1,000 people with this type of cancer can now be offered the drug. Clinical trial evidence showed that, compared with standard chemotherapy, Enhertu helps people with HER2-low advanced breast cancer live longer and delays the time before their cancer gets worse. The BBC reported that it can give patients almost seven extra months to live on average, with some living up to three years longer.
- ~1,000People a year expected to be eligible in England
- ~7 monthsAverage extra survival reported by the BBC
- 2023Year the drug became available in Scotland
- 26Other European countries where it is available
Why NICE changed its mind
In 2024, NICE said Enhertu was not good value for money, and campaigners and charities have pushed for access ever since. NICE said its independent committee had been unable to recommend it at the price proposed by the companies, and that it remained the only breast cancer drug the body had been unable to recommend since 2018, a period in which 25 other breast cancer treatments received positive recommendations.
What changed was the way NICE judges value, not the clinical evidence. As part of the UK–US Pharmaceutical Pricing Agreement, the cost-effectiveness thresholds NICE uses were increased in April; the BBC reported the upper limit per quality-adjusted life year moved from £30,000 to £35,000, with the UK government agreeing to spend more on medicines. A new, more detailed method for assessing quality of life was published on 27 August 2026. NICE said the two changes allowed a commercial solution to be agreed. The BBC understands that the companies have not substantially lowered the drug’s price since it was first rejected.
NICE’s recommendation is still described as final draft guidance and is open to appeal until 5 p.m. on 7 October 2026.
Reaction
Health Secretary Yvette Cooper said Enhertu “can be life-changing” and paid tribute to campaigners and charities who kept pressing for it. Claire Rowney, chief executive of Breast Cancer Now, said the campaigners’ persistence had paid off, but that thousands of people had missed out on the drug in the meantime and many had died. Patients also spoke of mixed emotions. Kate Wills, 51, who has HER2-low breast cancer that has spread to her bones and lungs, told the BBC she cried with relief when she heard, while thinking of friends who did not get the treatment in time.
What happens next
Doctors in England can now discuss Enhertu with eligible patients. Whether it is suitable for a particular person depends on their diagnosis, previous treatment and overall health, and is a decision for their cancer team. The formal process in Wales is expected soon, and the appeal window on NICE’s final guidance closes on 7 October.
