This was the reaction of a woman with secondary breast cancer devastated upon hearing that a new treatment called Kadcyla had been rejected by the Scottish Medicines Consortium (SMC):

"I have young children and need to be here as long as I can for them."

This was a rejection that means this drug will not be available on the NHS in Scotland. It is a decision that will shorten the lives of hundreds of women across this country.

This is a drug that has been shown to be highly effective in providing women with secondary breast cancer with an average of six extra months of life, which is hugely valuable to women with a terminal disease.

However, following yesterday's decision Kadcyla is now out of reach for both the women who need it and the oncologists who want to be able to provide it. The drug has already been rejected by decision makers in England largely due to its high cost and we had hoped a new decision-making process adopted by the SMC might have meant a different decision would be made in Scotland.

This was because the new process gives a much greater voice to patients and clinicians through a new stage called Patient and Clinician Engagement (Pace).

This is deliberately designed to add significant weight to the views of those affected by the relevant condition and those who prescribe drugs to treat it.

Kadcyla received powerful and compelling support from patients, patient groups and health professionals at the Pace stage and was well presented at the public meeting of the SMC when the final decision was made.

So it is disappointing that the strength of support for Kadcyla was not enough to overcome the high costs involved, something that was always going to make it difficult for the SMC to approve.

Despite this, Breakthrough fully supports Pace and believes it has the potential to be the catalyst required by the Scottish Government to increase the number of medicines approved by the SMC. We look forward to seeing a positive outcome from these changes for many "end-of-life" drugs in the future.

We recognise it is still early days and it is encouraging that the SMC is open to listening to the views of stakeholders as it beds in.

Yet Kadcyla is a drug for women with a terminal disease who have pretty much run out of other effective treatment options.

These women are facing conversations with family and friends that none of us would want to have.

They want, need and deserve the chance for more time, until the next treatment might come along or at least until their next holiday.

This is a drug that commands widespread support. In addition to oncologists, all four breast cancer charities in Scotland want to see it made available, as do more than 1,800 members of the public who signed a petition calling for better availability of breast cancer medicines.

And many women with secondary breast cancer we spoke to wish to see it approved. Because of the cost of this drug, this chance has been taken this away.

Access to drugs for people who really need them is a substantial ongoing problem.

As we understand more about diseases such as breast cancer and develop more targeted treatments that work for fewer women with specific types of the disease, there seems to be an almost certain increase in costs.

This will inevitably put more pressure on the NHS in Scotland. The SMC has added more flexibility to their processes to give drugs the best chance of being approved.

We now need the manufacturers of the drugs to offer them at a price the NHS can meet; and meet them we must.

As the same women we spoke to recently said: "The only thing that keeps me going is the thought of new drugs, like Kadcyla, that could give me longer with my family and ensure that I can be a 'normal' mother for as long as possible."