NHS England has today announced that an agreement has been reached with Roche Pharmaceuticals on the commercial aspects of the use of metastatic breast cancer drug Perjeta (pertuzumab), which now unlocks the final stage of NICE’s appraisal and opens the way for continued access for NHS patients in England.
Perjeta, taken in combination with trastuzumab and docetaxel, is a first-line treatment for patients with HER2 positive metastatic breast cancer. It extends the time that patients are able to live without their breast cancer progressing by an additional 6 months – and gives nearly 16 months of additional life – compared to the alternative treatment option of trastuzumab and docetaxel alone.
NICE began an appraisal of Perjeta in 2012, and provisionally rejected it for routine commissioning on the NHS in 2013, but final guidance on Perjeta was never published. Perjeta has since been available to patients in England for over four years on the Cancer Drugs Fund (CDF) and has become established as the standard of care for patients with this type of breast cancer.
NICE resumed its appraisal of Perjeta as a result of changes to the CDF announced last summer. Previously, companies would propose a price to which NICE would say ‘yes’ or ‘no’ to the drug being made available – but NHS England now has more direct involvement with industry, working closely with NICE, to help to find deals that work for patients and taxpayers.
With NHS England and Roche having agreed a confidential arrangement on the use of the drug, NICE’s independent appraisal committee will now review this additional information before issuing guidance. Meanwhile the drug remains available for new and existing patients via the CDF.
Baroness Delyth Morgan, Chief Executive at Breast Cancer Now, said:
“This is exceptionally good news for patients and their doctors, and we very much hope that NICE will now be able to approve Perjeta as soon as possible. The impact that this treatment has had, and will hopefully now continue to have on the NHS, for thousands of women living with incurable metastatic breast cancer and their loved ones cannot be underestimated.
“Perjeta is an indispensable and life-changing drug, offering women with incurable breast cancer nearly 16 extra months to live compared to other treatments. We’re thrilled that, once more, tough negotiation and flexibility by NHS England and NICE, and the willingness of Roche to put patients first and compromise on price, is set to ensure that thousands of women can be given precious extra time to live.
“This step shows quite clearly that robust deal-making is possible and can achieve real value for money for the NHS and the taxpayer. With uncertainty continuing to surround the consideration of combination treatments for NHS use, we hope that Perjeta will prove a precedent rather than an exception.”
Bonnie Fox, 40 from Croydon, was 37 when she was diagnosed with incurable metastatic breast cancer in July 2015 – her son Barnaby was just four months old. She began taking Perjeta in combination with Herceptin, which has now kept her disease stable for over 27 months:
“I am absolutely thrilled to hear that Perjeta could soon be made routinely available for thousands of other women on the NHS in England. I owe so much to this fantastic drug combination – which has kept my cancer stable and has kept me feeling incredibly well for almost two and a half years now.
“I will never be free of breast cancer, but Perjeta has enabled me to lead a relatively normal life – to work, to travel and continue being a busy mum which means everything to me. I’m delighted that so many other women could now be able to benefit too.”
With Perjeta not yet available in other parts of the UK, we now urge Roche and the devolved nations to work together to ensure that this treatment can be made routinely available to all eligible NHS patients across the UK, as soon as possible.