Yes, and the point about Kadcyla is that, initially, the manufacturer had a cost price that was simply too high for the health service to pay, and that was the advice that health Ministers were given. That’s why the drug wasn’t available. There’s now been a reconsideration, and that’s very welcome. But the challenge is for any medication, whether it’s for Perjeta or any other drug, that there’s a balance between effectiveness in clinical terms and the cost-effectiveness of it as well.

In the individual patient funding request process that we collectively agreed to run through, that came out very clearly as a unanimous point from the panel: about not losing sight of the fact that there is a cost to this. Every penny we spend on one particular treatment is a penny and a pound that we don’t spend on other treatments as well. So, that balance has to be maintained, and I would again encourage manufacturers to get involved at an early point to discuss the effectiveness and the cost-effectiveness of their treatments. What that means is them having genuine access to the service to actually understand more about the development of the treatment as well as more people taking it, because otherwise we’ll continue to have these emotionally driven campaigns about people who think that a drug may offer them a chance to extend life or to save life. But all of our understanding is that, actually, you can’t simply pay any price for any treatment. That’s really difficult, when you look someone in the eye and say, ‘I think that this potential treatment that you want to have is too expensive’, but if we don’t do that, then our service becomes unaffordable. If we’re not prepared to do that, potentially we risk the whole service that does so much good and so much positively as well. So, if we can’t hold the line about having an evidence-led approach to this, then I think we actually risk and undermine the whole service. That’s a difficult point, but I think it’s absolutely the right one and it’s certainly the unanimous view of the IPFR panel in the recent reports to all of us in the last few months.