NICE, Enhertu, and the US-UK drug deal: What other drugs could be in the pipeline and at what cost?

AI Summary

NICE approved trastuzumab deruxtecan (Enhertu) for NHS use after changes to its cost-effectiveness thresholds and negotiations over the drug’s price. The changes followed a US-UK deal under which the UK agreed to spend more on innovative medicines, alongside campaigning by patient groups.

Why did NICE change its mind and approve Enhertu?The National Institute for Health and Care Excellence’s decision to recommend the life extending breast cancer drug trastuzumab deruxtecan (Enhertu) on the NHS comes after successful negotiations over its cost.In 2024 NICE ruled that it was not cost effective for use on the NHS.1But NICE said that recent changes to its cost effectiveness thresholds for assessing new drugs and new methods for assessing quality of life meant that it was now recommending the treatment.In April 2026, NICE increased the upper threshold range it uses when evaluating new medicines from £20 000-£30 000 per quality adjusted life year (QALY) to £25 000-£35 000.2This change was made because of a trade deal with the US, whereby the UK agreed to spend 25% more on “innovative” new medicines.Charities and patient groups also lobbied hard for Enhertu to be made available on the NHS in England.3Will...