the cost of a 'miracle' drug that can add six months to the life of women with terminal breast cancer could stop it becoming available on the public health system.
Kadcyla attacks cancer cells in a way which results in fewer chemotherapy side effects such as hair loss - but it comes at an average cost of €80,000 per patient.
The drug is designed for women who have HER2-positive cancer, which is inoperable, and has spread to other parts of the body. It is not a cure for the disease, but in trials it has extended life by an average of 5.8 months.
The HSE is considering whether to fund the treatment for patients in Ireland but the national drug watchdog has already ruled the treatment is too expensive.
The National Centre for Pharmacoeconomics (NCPE) acknowledged its treatment value but has recommended to the HSE that it is not "cost effective." A HSE spokeswoman told the Irish Indpendent that despite the NCPE recommendation, no final decision has yet been made on the treatment despite its high cost.
She confirmed discussions on pricing and related issues are "still ongoing" with the pharmaceutical giant Roche, which makes Kadcyla.
The product will be considered by the National Cancer Control Programme Therapeutic Review Process and the HSE "in the near future" when discussions with Roche have concluded.
There has been controversy in Britain, where Roche has been accused of blocking patients from receiving the drug, by refusing to cut costs to make it affordable for the National Health Service.
Rohce say Kadcyla is already routinely available in several European countries, including Sweden, Denmark, Austria, Finland, Norway and Switzerland
Kadcyla, also known as trastuzumab emtansine, is weight- based and is administered every three weeks.
It took 30 years to develop and contains a potent chemotherapy element which it deposits directly inside the cancer cells.
The drug seeks out and destroys these cells, attacking them from within.
Its novel action means it is unlikely to cause the side effects, such as hair loss, seen with many other types of chemotherapy.
The cost of treatment will vary from patient to patient depending on weight and how long treatment continues.
At a body weight of 72 kilogram, the average cost per patient would be approximately €65,000 to €69,000.
At a body weight of 73kg, the amount would rise from €80,000 to €85,000 per patient. The five-year cost to the taxpayer could be between €11m and €21m.
About 2,600 women are diagnosed with breast cancer annually in Ireland - and up to 30pc are classified as HER2-positive.
Kathleen O'Meara, Head of Advocacy and Communications at the Irish Cancer Society said it wants Irish patients to have access to the most up-to-date and cutting edge oncology treatments, including drugs.
"However, we believe they must be appropriately priced. You cannot put a price on life but we have to be able to put a fair price on drugs," she added.