Pharmaceutical partners AstraZeneca and Daiichi Sankyo are reportedly close to finalizing price terms with England’s National Institute for Health and Care Excellence (NICE) that would permit the use of Enhertu for a subgroup of metastatic breast cancer patients with low HER2 expression. While sources familiar with the talks describe progress, they caution the arrangement is not guaranteed and could unravel because of a range of factors, including anticipated changes in the UK government.
Enhertu, a drug co-developed by AstraZeneca and Daiichi Sankyo, has demonstrated an average survival improvement of about six months for certain patients. Despite this clinical benefit, NICE previously judged the therapy too costly for routine funding in England and Wales, leaving an estimated 1,000 women who might benefit from the drug without access under current arrangements.
People involved in the discussions told reporters that adjustments tied to the US-UK trade deal influenced NICE’s stance. The trade agreement incorporated language reflecting criticism from then-President Donald Trump about higher US drug prices compared with some European markets. That language reportedly raised the threshold at which medicines are judged to represent value for the UK’s National Health Service, which in turn has been cited as a factor enabling progress toward a deal for life-extending treatments such as Enhertu.
Those same sources indicated that other contract elements and concessions from the manufacturers have helped move negotiations forward. If an agreement is reached, the NHS in England is expected to secure a price below that paid by many other European countries. Enhertu is already accessible across most EU states and in the United States.
Representatives for AstraZeneca and Daiichi Sankyo have publicly said they remain in discussions with NHS England and NICE to support patient access to Enhertu for those with low HER2 levels and metastatic breast cancer. Separately, AstraZeneca announced a £300 million investment in the UK following the US-UK trade deal.
Market and sector implications
- Pharmaceutical and healthcare payers - A pricing concession that enables NHS coverage would affect payer budgets and set a precedent for valuing life-extending oncology medicines.
- Equities in pharmaceuticals - Any formal deal could alter investor expectations around revenue trajectories for drugs with constrained access, though the current reports do not confirm final commercial terms.
Process and uncertainty
- The negotiations remain ongoing and are not finalized - political shifts in the UK government and remaining contractual details present material uncertainty for patients and markets.
- The expected NHS price is reported to be lower than many European peers, but the precise commercial structure and timing were not disclosed by the parties quoted.