Breast cancer drug Kadcyla 'too expensive' for NHS
A life-extending breast cancer drug will not be routinely offered on the NHS in England and Wales because it is still too expensive, says a watchdog.
Women in England will be able to get Kadcyla through the Cancer Drugs Fund, but the price tag per patient - £90,000 at full cost - is too high to widen access, say the draft NICE guidelines.
NICE criticised manufacturer Roche for not making it more affordable.
Roche says discussions are continuing, meaning a resolution is still possible.
Kadcyla can add about six months of life to women with incurable disease.
It is used to treat people with HER2-positive breast cancer that has spread to other parts of the body and cannot be surgically removed.
Roche, recently agreed a significant price discount with NHS England to stop the drug being taken off the Cancer Drugs Fund - a special fund set up by the government to help people in England access costly cancer drugs that are not routinely available on the NHS.
But the Swiss pharmaceutical company offered a different, smaller discount to NICE for regular NHS use of Kadcyla (Trastuzumab Emtansine) in England and Wales.
NICE says this undisclosed figure is still too high to justify against the drug's clinical merits.
Any person currently receiving the treatment can continue until they and their doctor consider it appropriate to stop, however.
Kadcyla is not available on the NHS in Scotland either.
Sir Andrew Dillon, NICE chief executive, said: "We recognise that Kadcyla has a place in treating some patients with advanced breast cancer, and we have been as flexible as we can in making our recommendation. However, the price that the manufacturer is asking the NHS to pay in the long term is too high."
Roche and other consultees now have until November 17 to challenge the draft guidance.
Roche said: "We need a unified approach, and, moving forward, it is imperative that we work together to build a pragmatic, flexible and sustainable system for assessing medicines that prioritises clinical value. Only then will we be able to ensure the best outcomes for people with cancer in the UK.
"This announcement comes less than two weeks after Kadcyla was retained on the Cancer Drugs Fund. Roche has demonstrated that, when given the opportunity to come to the table with all parties, we can come to an agreement and do the right thing for patients."
Dr Caitlin Barrand, from the charity Breast Cancer Now, said the news was hugely disappointing.
"It's time that the prime minister showed real leadership on this issue," she said.
"People living with incurable cancer don't have time to lose, and a fairer, more flexible system that enables access to the best treatments available on a routine, UK-wide basis is long overdue."
The Cancer Drugs Fund is due to end in March 2016. The government says a replacement is likely to be brought in from April 2016, although there are no details yet.