Giving hope to those affected
by secondary breast cancer
Research. Support. Education.
Giving hope to those affected
by secondary breast cancer
29th May 2026 by Sarah Thomas Education
At Make 2nds Count, our goal is to ensure that every person living with secondary (metastatic) breast cancer across the UK has equitable access to life-extending treatments.
Today, in partnership with Breast Cancer Now and METUPUK, we have published an open letter to the newly appointed Chair of the Scottish Medicines Consortium (SMC), Dr Robert Peel. We are calling for urgent reform to the drug appraisal process to stop patients in Scotland from being left behind.
When new, innovative drugs are developed, they go through separate approval processes across the UK. Recently, we joined the National Institute for Health and Care Excellence (NICE) appraisals for England, Wales, and Northern Ireland to get two pioneering targeted treatments approved. Sadly, these same drugs were rejected by the SMC for patients in Scotland last year.
This has led to a widening inequity in cancer care, where patients in Scotland are denied access to targeted therapies which have become the new standard of care around the world. Patient advocacy is vital to challenging these decisions, which is why we are actively participating in three critical upcoming SMC appraisals:
Resubmission of elacestrant
Resubmission of capivasertib
New submission of inavolisib
While we are incredibly pleased that pharmaceutical companies have moved forward with these resubmissions, an approval by the SMC is only half the battle if systemic barriers remain unaddressed.
Our open letter directly challenges the procedural barriers that keep precision medicines out of reach for Scottish patients:
1. The "Chemotherapy Comparator" Trap
Right now, the SMC evaluates new targeted treatments against chemotherapy. However, clinical trials are usually designed to compare a new treatment against the current standard targeted or hormone therapies - which is exactly how NICE assessed them. Forcing companies to show comparative data against chemotherapy creates an unrealistic hurdle as this is not how clinical trials are designed. Patients deserve access to the standard of care, not being left with chemotherapy as their only option.
2. The Genomic Testing Gap
A drug approval means nothing if clinicians cannot test patients to see if the treatment is suitable for them. Currently, there is still no agreed expansion of genomic testing in the Scottish Cancer Test Directory, nor an established funding mechanism for it. Scotland risks a devastating reality where life-saving treatments exist, but patients are denied them simply because their healthcare teams cannot perform the necessary tests.
"We are deeply concerned that people with incurable metastatic breast cancer in Scotland are now facing fewer treatment options, earlier reliance on chemotherapy - which we know many patients would prefer to avoid - and a widening inequity in access to precision medicine compared with the rest of the UK."
We have asked the new SMC Chair to raise these urgent concerns directly with the new Cabinet Secretary for Health and Social Care to secure long-term, sustainable access to genomic testing. It's time to build a fair system that values patient outcomes and ensures access to targeted treatments.
You can read our full open letter here. Together, with METUPUK and Breast Cancer Now, we’ll keep pushing for every person living with secondary (metastatic) breast cancer across the UK to have equitable access to life-extending treatments.
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