Thousands of prostate patients denied drug that can extend life by five months in watchdog U-turn

10,500 British men have advanced treatment resistant prostate cancer



New drug Enzalutamide can extend life by more than 18 months

It was initially recommended for NHS funding last October



Revised draft guidance imposes curbs denying many men chance to use it

Thousands of men with advanced prostate cancer could be denied a new drug after a U-turn by the NHS rationing body

Thousands of men with advanced prostate cancer could be denied a new drug after a U-turn by the NHS rationing body.

Enzalutamide extends life by at least five months in men who have run out of treatment options – with some patients surviving more than 18 months.

It was initially recommended for NHS funding last October but revised draft guidance issued today imposes curbs that will deny many men the chance to use it.



It will be banned for patients in England previously treated with abiraterone, another new drug currently used in advanced cases. Men in Scotland are getting enzalutamide without restrictions.

Rationing watchdog the National Institute for Health and Care Excellence (Nice) says lack of evidence about the two drugs has led to its revised decision, which is now out for consultation.

Cancer specialists are outraged, saying it is a perverse U-turn based on fears about the cost.



Around 10,500 British men have advanced prostate cancer that is resistant to standard hormone treatments.

Doctors say enzalutamide could help turn prostate cancer from a killer disease into a chronic illness.

Dr Alison Birtle, consultant oncologist at the Rosemere Cancer Centre, Royal Preston Hospital, described the ruling as a tragedy.



‘Thousands of men have been prescribed abiraterone or are using it in trials, and they will be denied this new drug at some point,’ she said.

‘New drugs have shown that advanced prostate cancer can be turned into a chronic disease, with men having good quality of life for months or even years. They are able to work and reach the milestones in life that matter to them.

‘I’m outraged by this perverse decision. This would not happen in breast cancer.’

Enzalutamide, a new type of hormone treatment, was assessed in 1,199 patients with advanced prostate cancer who had previously received chemotherapy. Their survival rates were significantly extended, with almost half having a better quality of life as a result.

Around 10,500 British men have advanced prostate cancer that is resistant to standard hormone treatments

Enzalutamide, which is a pill taken at home, costs around £25,000 for an average course of treatment. But manufacturer Astellas Pharma has reduced the price through a patient scheme that makes it cost-effective, according to Nice.

Owen Sharp, chief executive at the charity Prostate Cancer UK, criticised Nice. ‘Adding this restriction to their draft decision, without any explanation, leaves hundreds of men, who have few treatments anyway, with no hope of accessing enzalutamide,’ he said.

‘Nice is playing fast and loose with men with prostate cancer in the advanced stages of the disease who may become resistant to other treatments, and what’s worse, without saying why.





‘We will fight this decision, but it will not help the men who could be benefiting during this delay. We hope Nice follow the decision made in Scotland, and allow clinicians to make the decisions about what drugs are best for patients.’

Professor Jonathan Waxman, a leading prostate cancer specialist, said Nice was an organisation ‘not fit for purpose’ that persists in using a faulty system for rationing drugs that disadvantages patients in England.

‘It continues to evaluate drugs using calculations that do not reflect reality and exaggerate the cost,’ he said. ‘These nonsensical decisions are made on behalf of patients but conflict with what specialists consider is best for them.’

He accused Nice of creating a postcode lottery. ‘This iniquitous guidance means men in England will be treated differently from Scotland,’ said Professor Waxman.