NHS U-turn brings Enhertu to 1,000 women — after two years of delay

• About 1,000 women a year in England with HER2-low advanced breast cancer can receive Enhertu from Thursday, 17 September. ¹
• The drug extends median overall survival to 23.4 months, compared with 16.8 months for standard chemotherapy in the pivotal trial. ²
• NICE rejected Enhertu in July 2024 because its estimated cost per quality-adjusted life year was above the range it considered affordable for the NHS. ³
• The reversal followed a new commercial agreement with AstraZeneca and Daiichi Sankyo, alongside changes to NICE’s cost-effectiveness methods and spending threshold. ¹⁴

For patients, the change is immediate in principle: Enhertu is now recommended for adults with HER2-low metastatic or unresectable breast cancer whose disease has progressed after chemotherapy, or returned during adjuvant chemotherapy or within six months of finishing it. The drug’s trial results showed nearly twice as much time before disease progression as chemotherapy — 9.9 months against 5.1 months. ²⁵

The decision also exposes the power of price negotiations over who gets extra time. NICE accepted that the treatment worked in 2024 but said the price was too high; the drug was then available in Scotland but not England. The new agreement has not disclosed how much the manufacturers cut their price, or how much more the NHS will now pay under its revised rules. NICE and NHS England have announced access from 17 September, but the public material does not establish that every eligible NHS trust has its local prescribing and supply arrangements operating on the same day. ¹⁴

Footnotes

1. The Guardian, “Women in England with incurable breast cancer to get life-extending drug on NHS”, 17 September 2026 ↩ ↩² ↩³

2. New England Journal of Medicine, “Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer” ↩ ↩²

3. NICE, TA992: Trastuzumab deruxtecan for HER2-low metastatic or unresectable breast cancer after chemotherapy ↩

4. The Independent, “Breast cancer patients given ‘new sense of hope’ as life-extending drug made available after U-turn”, 17 September 2026 ↩ ↩²

5. NICE, TA992 committee discussion and treatment eligibility ↩