Thousands of women in England with incurable breast cancer will soon gain access to a life-extending treatment following a new agreement to provide the drug Enhertu on the National Health Service (NHS). The decision marks a significant policy change after the drug was initially rejected in 2024 on the grounds of cost.

Enhertu is used to treat advanced breast cancer that has spread throughout the body and targets a protein known as HER2, which can promote rapid tumor growth. While the drug was already available on the NHS for patients with high HER2 expression (HER2-positive breast cancer), access had been denied for those classified as HER2-low—a subgroup representing approximately 1,000 patients per year in England.

Clinical trials have shown that Enhertu can extend progression-free survival from around five months to nearly ten months compared with standard chemotherapy. Median overall survival among patients taking the drug increased by approximately six months, rising from 16.8 months to 23.4 months. Despite these benefits, the National Institute for Health and Care Excellence (NICE), which evaluates the cost-effectiveness of treatments for NHS use, initially rejected the drug due to its price.

Following renewed negotiations involving NICE, NHS England, and the pharmaceutical companies AstraZeneca and Daiichi Sankyo, a “commercial solution” was reached that made the drug financially viable for NHS provision in England. The announcement came recently, reversing the previous decision and enabling broader patient access.

Campaigners and charities, including Breast Cancer Now, welcomed the announcement as a hard-won victory after nearly two years of advocacy. Sophie Blake, a 53-year-old patient with HER2-low metastatic breast cancer, described the earlier rejection as devastating and said the new decision offers hope for "more precious time." Blake had actively participated in protests and gathered over 300,000 petition signatures demanding NHS access to Enhertu.

Breast Cancer Now’s chief executive, Claire Rowney, emphasized the significance of the decision for patients and their families, calling it “a momentous day” that provides new opportunities for life extension. The charity also acknowledged those who had missed out on treatment and expressed gratitude to the individuals and groups who campaigned persistently for access.

Helen Knight, director of medicines evaluation at NICE, noted that the decision came too late for many patients but stressed the importance of balancing NHS spending to ensure resources are allocated effectively across services.

Enhertu became available in Scotland in December 2023 and has also been approved in 27 European countries. Efforts to secure access in England were reportedly complicated by initial resistance from drug manufacturers to reduce the price. Political figures, including members of the Labour Party, had worked behind the scenes to facilitate a deal.

With this agreement, Enhertu will now be routinely available on the NHS for eligible patients in England, offering a new treatment option for those living with HER2-low advanced breast cancer.