Prostate cancer drug disappointment
15th August 2014 – There's disappointment over the NHS rejecting a new prostate cancer drug called abiraterone for some men with the condition.
The National Institute for Health and Care Excellence (NICE) has confirmed its earlier draft guidance against abiraterone for the NHS in England and Wales.
NICE says the benefit doesn't justify the price to the NHS. One prostate cancer charity is calling the decision a 'kick in the teeth'.
This is the second high profile case this month of a life-extending cancer drug being turned down on cost grounds. Earlier this month, NICE found good evidence to support trastuzumab emtansine for advanced breast cancer, but said it couldn't justify the high cost.
NICE has already recommended abiraterone as a prostate cancer treatment after chemotherapy, but the latest decision covers its use at an earlier stage.
The latest assessment covered abiraterone for prostate cancer in men where the disease has spread despite having hormone therapy, but who have few symptoms, and when chemotherapy would not yet have been recommended.
Abiraterone is a hormone therapy to help stop testosterone reaching the prostate gland, and to stifle the tumour.
In a statement, Sir Andrew Dillon, NICE chief executive says: "We know how important it is for patients to have the option to delay chemotherapy and its associated side effects, so we are disappointed not to be able to recommend abiraterone for use in this way.
"However, the manufacturer's own economic model demonstrated that the drug does not offer enough benefit to justify its price."
Abiraterone costs around £2,930 a month before a confidential NHS discount.
Abiraterone: Developed in the UK
Abiraterone was discovered and developed at The Institute of Cancer Research in London. It is critical of NICE's decision and the way it reached it.
In a statement, Professor Paul Workman, interim chief executive of The Institute of Cancer Research says: "We're very disappointed that men with prostate cancer will miss out on the chance to have abiraterone much earlier in their course of treatment as a consequence of this decision.
"There is clear evidence that use of abiraterone before chemotherapy is beneficial for patients, and gives them longer, healthier lives. We urge NICE and the drug's manufacturer to get back to the table, and explore every option for making abiraterone available to these men at a price that is affordable for the NHS."
Cancer Drugs Fund
Prostate Cancer UK says abiraterone before chemotherapy has become the second most requested drug on England’s Cancer Drugs Fund.
In a statement, the charity's chief executive Owen Sharp criticised NICE's decision making: "It's a fiasco. This decision is a kick in the teeth for men with advanced prostate cancer. For many this presented a vital opportunity for extra time with loved ones and a chance to delay chemotherapy and the debilitating side effects which come with it.
"An inflexible NICE process plus the drug company's inability to produce all the requested data has led to this being just the latest in a string of hugely disappointing rulings on prostate cancer drugs. Once again men in England will have to take their chances with the Cancer Drugs Fund, with men in Wales and Northern Ireland left with nowhere to turn."
The drug's manufacturer, Janssen says it will appeal against the NICE decision. In a statement, its medical director Dr Peter Barnes says: "These men will eventually be able to receive abiraterone on the NHS after chemotherapy anyway, but will be denied the option of taking it earlier on in their illness."
Scotland's drug regulator SMC is due to assess abiraterone for use before chemotherapy next year.
Until final guidance is issued, local NHS groups will make their own decisions on funding abiraterone.