Following “long-awaited victory” in England, we call for fair access to Perjeta across the rest of the UK
The National Institute for Health and Care Excellence (NICE) has today approved metastatic breast cancer drug Perjeta (pertuzumab) for routine use on the NHS in England, following a commercial agreement between NHS England and manufacturer Roche Pharmaceuticals.
Perjeta, taken in combination with Herceptin (trastuzumab) and docetaxel (a chemotherapy drug), is a first-line treatment for patients with HER2-positive metastatic breast cancer. It gives patients with incurable breast cancer nearly 16 additional months of good-quality life, on average – compared to the alternative treatment option of trastuzumab and docetaxel alone.
NICE initially began an appraisal of Perjeta in 2012, provisionally rejecting it for routine commissioning on the NHS in 2013, however final guidance was never published. Perjeta has since been available to patients in England for over four years via the Cancer Drugs Fund (CDF), becoming established as the standard of care for patients with this type of breast cancer, benefitting around 1,300 patients each year.
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.
Baroness Delyth Morgan, Chief Executive at Breast Cancer Now, said:
This is the best news patients with HER2-positive breast cancer and their doctors could have hoped for. Perjeta is a truly life-changing drug and we are absolutely delighted and relieved that NICE has finally been able to recommend it for routine NHS use in England.
Perjeta’s benefits are extraordinary, offering women with incurable metastatic breast cancer over four and a half years to live – nearly 16 precious extra months with their loved ones compared to existing treatments.
While a long time coming, we’re thrilled that tough negotiation and flexibility by NHS England and NICE, and the willingness of Roche to put patients first and compromise on price, has again ensured thousands of women can be given more time to live.
However, major uncertainty continues to surround the appraisal methodology’s ability to cope with modern combination treatments, and it remains to be seen whether Perjeta will prove a precedent rather than an exception.
On access to Perjeta across the rest of the UK, Baroness Morgan added:
While Perjeta will now continue to be the gold standard of care in England, it has never been routinely available in Scotland, Wales or Northern Ireland. This is the most effective breast cancer drug in years and we must urgently see equality in access for NHS patients across the UK.
This long-awaited victory in England shows that robust deal-making is possible and can achieve real value for money for the NHS and taxpayer. Perjeta has been rejected three times in a row in Scotland, and the Scottish Government, Roche and the Scottish Medicines Consortium must come back together urgently to find a solution for Scottish patients.
With NICE decisions normally being followed in Wales and Northern Ireland, we now also hope Roche and the devolved nations will be able to agree deals to see Perjeta made routinely available in those parts of the UK for the very first time.