NHS England to Fund AstraZeneca's Enhertu After UK-US Pricing Deal
- NICE, which sets drug-funding recommendations for NHS England, will fund Enhertu (trastuzumab deruxtecan) for HER2-low metastatic or unresectable breast cancer after chemotherapy, reversing a July 2024 rejection on cost grounds.
- The reversal follows a UK-US pharmaceutical pricing deal that led NICE to raise its cost-effectiveness threshold and revise its appraisal methodology, making some costlier innovative drugs newly reimbursable.
- Enhertu, an antibody-drug conjugate co-developed by AstraZeneca and Daiichi Sankyo, has been reported in studies to meaningfully extend survival for this patient group versus chemotherapy alone, though the size of the benefit varies.
- An estimated 1,000 patients in England are expected to gain access, with treatment available within days of the decision.
NICE just permanently loosened its willingness-to-pay bar — as a negotiated line item in a bilateral trade deal, not a one-off cost-effectiveness review. That's the story here, not the roughly 1,000 patients gaining access: expect other governments squeezed between fiscal discipline and access pressure, and other pharma negotiators facing NICE, to point to this precedent. For AstraZeneca and Daiichi Sankyo, it de-risks Enhertu's ex-US rollout playbook: reimbursement fights in other cost-constrained markets (Canada, Australia, parts of Europe) just got a stronger comparator to cite. More broadly, this nudges the ceiling on what NICE will pay for high-cost ADCs and next-gen oncology assets generally, benefiting the wider oncology ADC pipeline queuing up for UK launch, not just this one drug. Watch whether AZ/Daiichi price other Enhertu indications, or future ADCs, against this new threshold.
England to cover AstraZeneca breast cancer drug, a result of U.K.-U.S. drug pricing deal ↗