[Editorial] Trastuzumab emtansine and cost-based decision making

On Dec 29, 2016, the National Institute for Health and Care Excellence (NICE) in the UK invited comments on their draft guidance for use of trastuzumab emtansine (Kadcyla) for advanced or metastatic breast cancer in patients carrying mutations in human epidermal growth factor receptor 2 (ie, patients who are HER2 positive). The cost of the drug, manufactured exclusively by Roche, is approximately £90 000 per patient per year, and is currently covered by the Cancer Drugs Fund. The NICE consultation remains open until Jan 20, with the recommendation that although there is evidence that trastuzumab is effective, it should not be made available on the National Health Service (NHS) owing to prohibitive cost.

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