A pioneering new breast cancer treatment will not be routinely available in England and Wales, the NHS drugs advisory body NICE is proposing.
The drug - Kadcyla - adds six months of life on average to women dying with an aggressive form of breast cancer.
NICE criticised makers Roche for not setting an affordable price, in its updated draft guidance.
The drug costs £90,000 per patient but Roche said it had offered a lower - undisclosed - price in recent talks.
The two organisations have been in negotiations since the first draft guidance from NICE (the National Institute for Health and Care Excellence), rejecting the drug, was published in April.