Women with advanced breast cancer ‘face a lottery over drug access’

Women with advanced breast cancer face a lottery over whether they will be able to access a drug that could extend their lives, a charity has warned.

Breast Cancer Now had been hoping drugs firm Gilead and NHS England would agree for Trodelvy to be provided free of charge to eligible patients, ahead of a National Institute for Health and Care (Nice) decision on wider NHS access next year.

The drug can benefit women with triple negative incurable secondary breast cancer.

Triple negative breast cancer is more common in women under 40 and affects about 15% to 20% of all women with the disease.

Gilead has said it will introduce a pre-reimbursement access scheme for Trodelvy shortly after licensing but Breast Cancer Now said this will not guarantee that all women who need the drug will be able to receive it.

The charity said the scheme will lead to an unfair system of “first come, first served”, or that the drug will only be available to those who can afford to pay for it privately.

Breast Cancer Now has asked Gilead how many patients could access the drug through the scheme but the numbers have not yet been confirmed.

The charity is calling on the public to sign its It’s Time For Trodelvy petition, which calls on Gilead to provide the drug free of charge on the NHS to all eligible women.

Baroness Delyth Morgan, chief executive of Breast Cancer Now, said: “The tragic reality is that despite today’s licensing of Trodelvy, women with incurable triple negative secondary breast cancer may now face an agonising wait of up to eight months to access this exciting new treatment that they so desperately need – and for many this will be too late.

“These women are paying the ultimate price for drug company Gilead’s failure to reach an agreement with NHS England which could have seen eligible patients accessing Trodelvy free of charge on the NHS from today, ahead of a decision around its routine use in 2022.

“This is a bitter pill to swallow. Just as both Amgen and AstraZeneca recently used the process in place to make this happen for lung cancer patients, Gilead must do the same for breast cancer.

“Gilead’s proposed pre-reimbursement access scheme falls alarmingly short of what’s needed and will not guarantee all eligible women access to Trodelvy.

“These women don’t have time to wait. Gilead must urgently do the right thing for breast cancer patients by reaching an agreement with NHS England so that all eligible women are granted access to Trodelvy without delay.

“Until then, with every extra day that goes by there will be women who heartbreakingly are denied the chance of more time to live.”

Dr Andreas Makris, co-chair of the UK Breast Cancer Group, said: “Trodelvy is a major advance for the treatment of secondary (metastatic) triple negative breast cancer, an aggressive form of the disease.

“Until now, these patients have been faced with limited treatment options.

“Trodelvy has been shown to help women with the disease to live longer and it’s vital that women in the UK are able to access it immediately to give them the best chance of having more time with their loved ones.”

Emma Metcalfe, 35, from Sheffield, was diagnosed with triple negative secondary breast cancer in January, a year after first being diagnosed with primary breast cancer during the Covid-19 pandemic.

She said: “Being told I had incurable breast cancer was a really dark time – having to tell my parents and brothers over the phone and lying awake cuddling my partner and crying together in the dark.

“I’m already on my second line of treatment since my secondary breast cancer diagnosis, my cancer is aggressive and doesn’t take long to outsmart whatever chemo drug we throw at it.

“I worry about my treatment stopping working and I’m painfully aware that I’m fast running out of options.

“That’s why Trodelvy is so important. I love my life and I still have so much more I want to do and this treatment could offer me more time.

“Knowing that Trodelvy is there but I can’t access, it is incredibly frightening.

“It’s heartbreaking to think I could miss out on this new drug by as little as a few months.”

Gilead has been contacted for comment.