A breast cancer drug the NHS said no to in 2024 is available in England from today

What happened

On Thursday 17 September 2026, the NHS in England began offering a breast cancer medicine called Enhertu to a group of patients who could not get it before. Enhertu is the brand name for a drug called trastuzumab deruxtecan, made by AstraZeneca and Daiichi Sankyo. It is given as a drip into a vein, in hospital. The change matters because of who it is for. Enhertu is now available for people with what doctors call "HER2-low" advanced breast cancer. That means the cancer has spread to other parts of the body, or cannot be removed by surgery, and the cancer cells carry a small amount of a protein called HER2 - not enough to be called "HER2-positive", but not none either. For years that group sat in an awkward gap, because targeted HER2 drugs were thought not to work for them. Standard chemotherapy was usually the next step. About 1,000 women a year in England are expected to be eligible. The decision came from NICE, the National Institute for Health and Care Excellence - the body that decides whether the NHS in England should pay for a new treatment. NICE had already looked at this drug once and said no. In July 2024 it turned Enhertu down for this group, saying the price was too high for the benefit it gave. That decision stood for more than two years. This week NICE reversed it. According to reporting on the announcement, three things changed: the drug companies agreed a confidential discount with NICE and NHS England; NICE raised the amount it is willing to pay for a year of good-quality life, from around £30,000 to around £35,000, in April 2026; and NICE updated the way it measures quality of life in its calculations. Patients in Scotland have been able to get Enhertu for this use for some years already, through a separate Scottish process. England has been the outlier.

Why this matters

If you or someone you love has secondary breast cancer, this is a new option where the list was short. Secondary breast cancer - also called metastatic or advanced breast cancer - cannot currently be cured. Treatment aims to hold the cancer back, keep symptoms under control, and give people more time. So a treatment that adds months, on average, is not a small thing. Claire Rowney, chief executive of the charity Breast Cancer Now, called it "a momentous day for thousands of people who will now have access to a drug that will give them the opportunity to gain precious time". Health Secretary Yvette Cooper said Enhertu "can be life-changing and this recommendation means NHS patients will finally benefit". There is a second reason this story matters, beyond breast cancer. It shows what the two-year gap actually was. The science did not change this week. The trial results NICE looked at in 2024 are the same ones it looked at in 2026. What changed was the price, and the rules NICE uses to judge price. That is worth understanding calmly rather than angrily. NICE has a fixed pot of NHS money, and saying yes to one expensive drug means less for something else. But it does mean "NICE said no" is not always the end of the story - and it is reasonable for patients to ask their team whether a previously rejected treatment has been looked at again. It is also a reminder that where you live in the UK can change what you are offered. Scotland, Wales, Northern Ireland and England each have their own approval routes.

What the evidence actually says

It is worth being clear about what the trial actually showed, because headlines about cancer drugs can promise more than the evidence does. The key evidence comes from a clinical trial comparing Enhertu with the chemotherapy normally used for these patients. Two numbers stand out, and both were reported alongside this week's announcement: - People given Enhertu lived for a median of about 23.4 months, compared with about 16.8 months for those given standard chemotherapy. That is a gain of roughly six to seven months. - The cancer stayed under control for a median of about 9.9 months on Enhertu, compared with about 5.1 months on chemotherapy. "Median" means the middle of the group. Half of people did better than that figure, half did worse. Some gain much more than seven months. Some gain very little. It is an average, not a promise, and no one can tell an individual patient in advance which half they will be in. Enhertu is also not a cure. The trial measured how long treatment held the cancer back and how long people lived - not whether the cancer went away for good. And it is not free of side effects. Like other cancer treatments, it can cause tiredness, sickness and low blood counts. It also carries a known risk of inflammation in the lungs, which is why people taking it are monitored. Your oncology team will explain the full picture for your situation. One more honest limit: eligibility is specific. This decision covers HER2-low breast cancer that has spread or cannot be operated on, in people who have already had chemotherapy. It does not apply to every breast cancer, and a HER2-low result has to be confirmed by testing tumour tissue.

Qurexa perspective

We are a Lincolnshire healthcare logistics and pharmacy delivery service, so we should be straight about this: Enhertu is a hospital treatment given through a drip. It is not something a delivery service can bring to your door, and nothing we do changes who is eligible. Where we do see the pressure is around the treatment. People having cancer treatment often end up managing a long list of other medicines at home - anti-sickness tablets, painkillers, steroids, mouthwashes, and whatever they already took for other conditions. Hospital appointments stack up, energy is limited, and getting to a pharmacy on the right day in a tired week is genuinely hard. That is the bit we can help with: getting regular prescriptions to the door, and helping people keep track of what to take and when. If that is useful to you or someone you care for, it is there. If not, the news here is the treatment, not us.

Practical advice

If this decision might be relevant to you or someone close to you, here is what is actually worth doing. **If you have secondary breast cancer:** - Ask your oncology team whether your cancer is HER2-low. This is not something you can tell from symptoms - it comes from tests on tumour tissue, and older samples can sometimes be re-tested. - Ask directly whether Enhertu is an option for you now, and if not, why not. It is a fair question and your team will be used to it. - If you were told no in the past because NICE had not approved it, that reason may no longer apply. Raise it again. **If you are supporting someone:** - Offer to come to the appointment and write things down. Most people remember only a fraction of what is said in a clinic room. - Practical help often beats advice: lifts, meals, picking up prescriptions. **For everyone:** - Do not stop or change any medicine because of a news story, including this one. - Stick to trusted sources on cancer treatment: the NHS website, NICE, Cancer Research UK, Breast Cancer Now and Macmillan. - If you notice a new breast lump, a change in shape, skin dimpling, or a change to a nipple, get it checked by your GP. Most changes turn out not to be cancer - but finding it early gives far more options. - If you are invited for NHS breast screening, take up the invitation. Screening is for people without symptoms; if you have a symptom, do not wait for a screening appointment.

What to know

The short version: - From 17 September 2026, the NHS in England is offering Enhertu (trastuzumab deruxtecan) to people with HER2-low advanced or inoperable breast cancer who have already had chemotherapy. About 1,000 women a year in England are expected to be eligible. - NICE rejected the same drug for this group in July 2024 on cost grounds. It changed its mind after a confidential price deal, a rise in its spending threshold in April 2026, and an update to how it measures quality of life. - In trials, people on Enhertu lived a median of about 23.4 months, compared with about 16.8 months on standard chemotherapy - a gain of roughly six to seven months on average. - It is not a cure, it has side effects including a lung risk that needs monitoring, and the "average" gain will be larger for some people and smaller for others. - Scotland has had access to this treatment for this use for some years already. - If you think it may apply to you, the next step is a conversation with your oncology team, not a change to anything you are currently taking. Sources: ITV News, "Life-extending breast cancer drug becomes available on the NHS in England", 17 September 2026, https://www.itv.com/news/2026-09-17/life-extending-breast-cancer-drug-becomes-available-on-the-nhs-in-england; International Business Times UK, "NHS Approves Breast Cancer Drug Rejected Two Years Ago After NICE Raises Spending Limit", 17 September 2026, https://www.ibtimes.co.uk/nhs-england-enhertu-breast-cancer-drug-access-1820273; Eastern Eye, "What is Enhertu and how could the new NHS breast cancer treatment help patients?", 17 September 2026, https://www.easterneye.biz/what-is-enhertu-and-how-could-the-new-nhs-breast-cancer-treatment-help-patients/; National Institute for Health and Care Excellence, "Trastuzumab deruxtecan for treating HER2-low metastatic or unresectable breast cancer after chemotherapy (TA992)", July 2024, https://www.nice.org.uk/guidance/ta992. This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. If you are having treatment for breast cancer, talk to your oncology team before making any decision about your care. If you notice a new or unexplained breast change, contact your GP.