ENHERTU and the changing economics of access to innovation in the NHS in England
NICE’s recommendation for routine NHS use of ENHERTU (trastuzumab deruxtecan) in HER2-low advanced breast cancer, announced on 17 September, brings a prolonged market-access process towards a close. The treatment’s clinical value was recognised during its original assessment in 2024, but NICE did not consider the economic case sufficiently robust to support routine commissioning. Over the following two years, patients and advocacy organisations made sustained calls for a solution, while routine NHS access remained unavailable. [1, 2, 3] The revised recommendation is significant beyond ENHERTU itself. It follows changes to NICE’s cost-effectiveness framework and comes amid a UK pharmaceutical pricing environment increasingly shaped by international considerations, including the UK–US pharmaceutical agreement. The decision therefore offers an early illustration of how greater economic flexibility may help innovative medicines reach NHS patients. An innovative treatment in an area of subs...
