Trastuzumab Deruxtecan

Ministers met with the manufacturers of Enhertu, AstraZeneca, and Daiichi Sankyo, in November 2024 to encourage them to engage constructively with NHS England and the National Institute for Health and Care Excellence (NICE) to reach a commercial agreement that would enable patient access for patients with HER2-low metastatic breast cancer. The Department also regularly engages with patient organisations.

Enhertu for HER-2 low metastatic breast cancer remains the only breast cancer treatment that NICE has been unable to recommend for patients in the last eight years. This was because, at the price offered by the company in 2024, the treatment was too expensive for the benefits it provided, and NICE concluded it was not cost effective. Despite NICE and NHS England offering unprecedented flexibilities, the companies were unable to offer Enhertu at a cost-effective price.

As part of the United States and United Kingdom trade arrangement, announced in April 2026, NICE is now using a new higher cost-effectiveness threshold. The update to the NICE cost effectiveness threshold has already made a direct difference for NHS patients with several treatments, including treatments for cancer, recommended that may not have been under the previous threshold.

Given these new circumstances, discussions involving NICE, the manufacturers, and NHS England have resumed to try to seek agreement on a commercial offer that would make Enhertu cost-effective. Discussions are ongoing with further discussions planned in June and July. NICE remains committed to getting the best care to patients and we understand the impact this decision has had on the breast cancer community.