Enhertu breast cancer drug now available on NHS in England after two-year campaign

For two years, women with a particular form of incurable breast cancer watched a drug sit just beyond their reach. Enhertu could extend their lives by an average of seven months—sometimes far longer, up to three years for some patients. It was available in Scotland. It was prescribed across 26 European countries. But in England, the National Institute for Health and Care Excellence rejected it in 2024, saying the cost was too high relative to the benefit. That decision set off a campaign that would consume the remaining time of people who could least afford to lose it.

Starting Thursday, that changed. Doctors in England can now prescribe Enhertu to patients with HER2-low metastatic breast cancer, the specific type that has spread beyond the breast. Wales is expected to follow. About 1,000 women a year will become eligible. Health Secretary Yvette Cooper called it life-changing. Breast Cancer Now, the charity that led much of the push, said the persistence of campaigners had finally paid off. But the organization's chief executive, Claire Rowney, added something harder: thousands of people had already missed out, and many had died.

Kate Wills is 51 and has HER2-low metastatic breast cancer that has spread to her bones and lungs. To look at her life on the surface—the demanding job, the marriage, the teenage and young-adult children, the social media feed of ordinary happiness—nothing announces that she is terminally ill. But she has been living with the knowledge that a drug existed that could buy her more time, and that the NHS would not pay for it. When she learned the decision had reversed, she wept. "I really can't believe it," she said. "I'm so relieved, I'm overjoyed." Her goal had been to stay alive long enough for her youngest child to finish school. Now she allowed herself to imagine being present for their weddings, for the people they would fall in love with. The relief was real. So was the weight of what came with it.

Jeannie Ambrose was 53 when she spoke to the BBC two years ago. She was full of fight then, angry at the position she was in. "I'm not ready to die yet," she said. "I want to stay alive, I want to keep living. I should be concentrating on enjoying time with my family and friends. I should not be campaigning, using the time I've got left to fight." She died in January. Kate thinks of her often—thinks of her friends who did not live to see this reversal, who spent their final months and years pushing for access to a treatment that might have given them more of both.

The reversal itself came not from the drug companies lowering their prices, but from shifts in how the NHS calculates what it will pay for medicines. A trade deal with the United States required the UK government to increase spending on pharmaceuticals. As part of that agreement, NICE raised the threshold for how much it will pay for each additional year of good-quality life a drug can provide—from £30,000 to £35,000 per QALY, the metric known as a Quality-Adjusted Life Year. In late August, NICE also introduced a more detailed way of measuring quality of life itself. These two changes were enough to shift the calculation. Patient campaigns, the organization acknowledged, had helped too.

Daiichi Sankyo and AstraZeneca, the drug's manufacturers, welcomed the decision. AstraZeneca called for stronger collaboration across the healthcare system to speed access to treatments in the future. Helen Knight, NICE's director of medicines evaluation, said she was pleased a "commercial solution" had made the drug available, but she knew the decision "comes too late for many families." Her role, she said, was to ensure NHS spending reflected the benefits medicines delivered while protecting resources for other essential services. It was a careful statement, acknowledging both the logic of the system and its cost.

Claire Rowney of Breast Cancer Now framed the moment differently. "We can finally say we did it," she said. But she called on the government, NICE, NHS England, and pharmaceutical companies to work together to fix what she called a broken system—one that forces people with incurable metastatic cancer to spend their remaining months and years fighting for treatments that could give them more time. For Kate, the thought of dying before she had to, "when there was a drug that I just could almost reach but couldn't get," had been unbearable. To know she can access it now, she said, is absolutely everything.