Today we heard that the Scottish Medicines Consortium (SMC) has rejected the pioneering secondary breast cancer drug Kadcyla (also known as trastuzumab emtansine) for routine use on the NHS in Scotland.
This follows the National Institute for Health and Care Excellence (NICE)’s rejection of the drug for use on the NHS in England in August.
Kadcyla is used for a certain type of secondary breast cancer and can offer patients on average an additional six months of life, often with limited side effects. This means that patients are able to enjoy a good quality of life – sometimes continuing with work, taking holidays or simply enjoying as much precious time as they can with their loved ones.
Secondary breast cancer isn’t curable so any additional, good quality time that drugs can provide to patients and their families is of enormous value.
This rejection will come as a huge blow for many women with secondary breast cancer – women who are now facing a future with fewer treatment options and less time with their families. I’ve been to the funerals of women this year who have died from secondary breast cancer. And I’ll be forced to explain to other women still living with this dreadful disease that there is an effective treatment out there that could help them, but that they can’t get it on the NHS.
Why has this happened?
Sadly, this latest rejection is just one symptom indicating a much wider ailment: the inability of breast cancer patients in Scotland, and the rest of the UK, to access the drugs they need.
Kadcyla was the first cancer drug to be assessed by the SMC since the introduction of a new process which increased patient and clinician engagement. Support for this drug has united the entire breast cancer community. Patients, families, carers, oncologists and all four breast cancer charities in Scotland have called for this medicine to be approved. It wasn’t enough.
But let’s not fall into the trap of thinking that the bodies tasked with assessing these drugs don’t care. I was at the SMC meeting where Kadcyla was discussed. It was tough to hear in person the incredibly difficult decisions that members have to make as to which drugs get approved and which do not. It seems that, within the present system, there really are no winners.
This is a deeply disappointing outcome, and while we recognise the very high cost of this medicine made it hard for the SMC to approve, it becomes more vital than ever that pharmaceutical companies do more to set the cost of new medicines at a price the NHS can afford.
What needs to change?
It’s clear we need to address the issue of access to drugs on a UK wide level. This is a problem that’s not going away – and as treatments become more effective and more expensive to produce, it’s only going to get worse.
That’s why Breakthrough Breast Cancer is calling for the next UK government to commit to working with NICE, the SMC and the pharmaceutical industry to find a sustainable solution that allows effective drugs to be made available at a price that the NHS can afford. Because if we don’t act now, more families will face a future without the women they love.
James Jopling is Breakthrough's Director for Scotland