NICE relents, ending postcode access to prostate cancer drug
Men in England with high-risk prostate cancer will finally be able to get treatment with a life-extending drug which has been available in Wales and Scotland for almost three years.
After a concerted campaign by patient groups, including Prostate Cancer UK, reimbursement authority NICE has published new guidance allowing hormonal therapy abiraterone – both Johnson & Johnson's Zytiga brand and generics – to be used to treat men with high-risk localised or locally advanced prostate cancer that has not yet spread elsewhere in the body.
Prostate Cancer UK said that allowing the NHS to use abiraterone for these earlier-stage patients, as well as those with more advanced, metastatic disease, could save the lives of around 3,000 men over the next five years.
The decision means Northern Ireland remains the only country in the UK where patients with this stage of prostate cancer are denied access to abiraterone, and the charity said it will "continue to push for men in Northern Ireland to have access to the treatment on the same basis as men in the rest of the UK."
One patient, 65-year-old Giles Turner from Brighton, chose to pay out of his own pocket for abiraterone when he discovered he would be unable to get the drug via the NHS, paying £250 per month, and is now in remission.
"I was shocked and angered that my postcode meant I was denied free access to a treatment that could halve my risk of dying and give me the best chance of a cure," said Turner, who has campaigned to overturn the disparity within the UK.
Last October, NICE also widened the NHS's use of abiraterone to include first-line treatment of hormone-sensitive prostate cancer (HSPC), having rejected that use in 2021, saying that the launch of generics had changed its cost-effectiveness calculations. The drug has been an option for several years for men with advanced prostate cancer that has stopped responding to other hormone therapies.
The new guidance follows data from two phase 3 studies showing that adding a two-year course of abiraterone to standard androgen deprivation therapy (ADT) for high-risk localised or locally advanced prostate cancer halved the risk of their cancer coming back after treatment and also halved their risk of dying from the disease.
The availability of generics of the drug in 2022 also meant that the cost of the drug to the NHS plummeted from thousands of pounds to less than £2.50 per day.
The new guidance is "a momentous, lifesaving victory for the thousands of men whose lives will now be saved," said Prostate Cancer UK's assistant director of health improvement, Amy Rylance.
The charity assembled a team of data experts, politicians, patients, researchers, and partners in NHS England to provide the definitive evidence needed to secure abiraterone on the NHS for men across the whole UK.
"It's terrifying to be told you've got a cancer that's likely to spread, [and] to then find out you can't access the treatment that science has proven to be your best chance at surviving is completely devastating," she added.
"We refused to accept this outcome for men, and we didn't stop until we changed it."
The charity has also been campaigning for widespread prostate cancer screening using PSA testing, and has said it will continue to push for this despite the UK government's decision last month to restrict testing to men with BRCA gene variants.
Photo by Towfiqu barbhuiya on Unsplash
