Women in the UK with advanced hormone receptor positive breast cancer will now have another treatment option, i.e. the CDK4/6 inhibitor ribociclib (Kisqali) with fulvestrant. This will be given after previous treatment with endocrine therapy such as tamoxifen or an aromatase inhibitor. In the UK, over 80% of drugs are approved for funding by NICE compared to about 25% by PHARMAC in NZ, and the UK’s system is geared for fast decisions while NZ has no time limits. We need a NICE system in here!!