Kadcyla (trastuzumab emtansine or TDM-1), is the first and only targeted chemotherapy drug for secondary breast cancer, and on average costs more than £70,000 per year per patient (see notes). It is part of a new generation of treatments tailored for advanced cancers that have stopped responding to conventional chemotherapy and radiotherapy techniques.
However, because of the high price of the drug, it now falls short of inclusion criteria for the Cancer Drugs Fund, and the clock is ticking for Roche to reduce the price of this drug before it is removed from the fund on 4th November.
The UK’s largest breast cancer charity, Breast Cancer Now, believes that responsibility now lies with the manufacturer to drop the price down to a level that the NHS can afford.
Baroness Delyth Morgan, Chief Executive at Breast Cancer Now, said:
“Time is running out for patients living with incurable secondary breast cancer for whom Kadcyla would be their next treatment option. The situation is becoming increasingly desperate; it’s time for Roche to act, and make this one-of-a-kind treatment available at a price that the NHS can afford.
“We need a completely overhauled system of pricing and access, but until this is finally in place, Roche must do the right thing and take steps to keep this amazing drug available through the Cancer Drugs Fund.”
A unique combination drug made up of trastuzumab (Herceptin) and a very potent chemotherapy drug, DM1, Kadcyla specifically targets HER2-positive cancerous cells leaving healthy cells relatively untouched, meaning that the side effects normally associated with chemotherapy treatment are reduced.
An average of six months of additional, good quality life is what this drug can promise on paper, but for many women it is years rather than months that Kadcyla can provide.
Julie Strelley-Jones, 44 from London and a mother of two young children, is currently living with secondary breast cancer and being treated with Kadcyla:
“I cannot express how angry I am at this decision. It is so wrong on every level.
“I have been on Kadcyla now for 18 months and my latest scan results showed no evidence of active cancer in the body at all and only scarring on the brain from two separate radiotherapy treatments that targeted two tumours in my brain. It shocks me to the core that this drug may not be available for others.”
Since NHS England announced that more cuts were due to be made to drugs currently available on the Fund, Breast Cancer Now has been flooded with phone calls and emails from supporters worried by what this will mean for them.
Connie Johncock, 25 from Kent, is living with secondary breast cancer. When her current treatment becomes ineffective, Kadcyla would be her next viable treatment option:
“No words come close to describing how important drugs like Kadcyla are to me...but actions speak louder than words and my treatment allows me to continue to do all the things I love and want to accomplish while still feeling like any other woman in her 20's.
“Kadcyla was going to be my next option and this decision has put a massive question mark over my future treatment.”
In December 2014, NHS England announced plans to re-evaluate some of the cancer treatments that were covered by the Fund in terms of both clinical effectiveness and cost in an attempt to make the money available work harder for patients. Following this re-evaluation, several pharmaceutical companies offered confidential discounts in order to allow their products to remain available to patients via the Fund. However, several drugs were still removed from the Fund in March 2015.
Now an additional list of ‘at-risk’ drugs – of which Kadcyla is one – has been published by NHS England giving the NHS, and respective pharmaceutical companies, two months’ notice to negotiate before the listed treatments are permanently removed from the Fund. Whilst nobody currently receiving a drug via the Cancer Drugs Fund will have their treatment discontinued, no new applications for those drugs will be accepted come November 2015.
Breast Cancer Now has campaigned for some time for the Government and the pharmaceutical industry to work together to address the ongoing issue of access and pricing for new and effective treatments for breast cancer. However, progress has been slow and neither government nor industry are any closer to a solution that works for the NHS, the industry, or for patients.
This petition, direct to the drug manufacturer, illustrates the desperate situation many patients are finding themselves in while they wait for change.
Breast Cancer Now believes that a temporary price drop in order to keep Kadcyla on the Cancer Drugs Fund is the only option now to ensure continued access for patients, until the wider problems with the system of access to drugs are worked through.
The Cancer Drugs Fund is due to expire in March 2016 and as yet it remains unclear how it will be replaced, if at all. A consultation on proposed changes to reform the current system that Breast Cancer Now eagerly awaits to see is due to be released by NHS England in coming weeks.
Sign the petition and support Breast Cancer Now’s Unlock Drugs Campaign
- Over 12 months, based on Roche’s stated cost of £5,900 a month, Kadcyla would cost the NHS £70,800.
- In August 2014 NICE estimated that Kadcyla would cost more than £90,000 per patient at its full list price.
- More information available on the NICE website.