Prostate cancer drug 'too expensive'

2^nd February 2012 - A new medication to treat advanced prostate cancer is too costly when set against the benefits to patients, the National Institute for Health and Clinical Excellence (NICE) has said in draft guidance.

NICE said it was "disappointed" not to be able to recommend abiraterone, also known by its brand name Zytiga, for use on the NHS in England and Wales, but that it did not believe the medication provided enough benefits to patients to justify the high cost - even with a discount offered by the manufacturer.

One cancer charity described the decision as "a bitter blow to thousands of men and their families".

Stopping testosterone

Abiraterone acetate, which is taken as a daily pill, is used to treat men who have already undergone chemotherapy. It works by stopping the body making the hormone testosterone. Most testosterone is made in the testes, but a small amount is made elsewhere. Shutting down the body's testosterone production can slow prostate cancer growth or even shrink it.

Results published last year of a Phase III trial showed that those treated with abiraterone plus the steroid prednisolone lived an average of almost four months longer than those given a placebo together with the steroid prednisolone.

The trial of abiraterone, which is manufactured by Janssen, involved 1,195 patients from 13 countries with metastatic advanced prostate cancer. Among those who took the medication, the risk of dying was cut by 35%, while there was a 36% increase in the average survival rate, meaning that men taking the medication lived for 14.8 months, compared with 10.9 months for those assigned the placebo.

'Disappointed'

Commenting on the recommendations, Sir Andrew Dillon, chief executive of NICE said in a statement: "Abiraterone is a drug that could potentially extend life by more than three months, compared with placebo. For patients one of the key benefits of this drug is that it can be taken orally at home.

We are therefore disappointed not to be able to recommend it for use on the NHS. However, it is an expensive drug and the independent advisory committee that made this decision did not feel the drug provided enough benefit to patients to justify the price the NHS is being asked to pay, even with the discount that the manufacturer has offered."

The draft guidance will now be submitted for consultation. Final guidance is expected to be announced in May, and until then NHS bodies must make funding decisions locally.

'Bitter blow'

However, the decision by NICE not to recommend the medication has brought fierce criticism from cancer charities.

Owen Sharp, chief executive of The Prostate Cancer Charity, said the announcement sent a clear message to men that investing in prostate cancer treatments was not a priority for the NHS. "This draft decision is a bitter blow to thousands of men and their families - and must be overturned," he said in a statement. He continued: "The drug is one of the biggest breakthroughs in the treatment of the disease for many years, and it will be devastating if this drug remains out of their reach when they need it the most.

"Abiraterone can increase the amount of time a man with advanced prostate cancer has left to live by an average of about four months and in a very human currency, this may give him the chance to walk his daughter down the aisle or see the birth of a grandchild."