Prostate cancer pill that can extend life by years and delay need for chemotherapy set for ban because it is not cost effective



Abiraterone gives at least four months’ extra life

Offered to men on NHS after treatment when they are running out of options

Last year, abiraterone used before chemo by 3,000 men in England

Some men have survived on it for almost five years

Chief executive of Nice said drug would not be cost-effective at this stage



The NHS rationing body is poised to ban the use of a drug that could delay the need for chemotherapy among men with advanced prostate cancer

The NHS rationing body is poised to ban the use of a drug that could delay the need for chemotherapy among men with advanced prostate cancer.

Abiraterone, which gives at least four months’ extra life, is offered to men on the NHS after treatment and when they are running out of options.

The pill’s manufacturer, Janssen, and campaigners want thousands to receive earlier treatment before chemotherapy, but draft guidance from the National Institute for Health and Care Excellence would ban this.

Last year, abiraterone was used before chemotherapy by 3,000 men in England through the Cancer Drugs Fund, which picks up the bill when a treatment is awaiting approval by Nice.

It was the second most requested treatment backed by the fund.

Doctors say the figures show the drug, which was developed by British scientists, is now more likely to be used before chemotherapy, and some men have survived on it for almost five years.

Sir Andrew Dillon, chief executive of Nice, said the drug would not be cost-effective at this stage of treatment.

A month’s treatment costs £3,000, but the NHS and the Cancer Drugs Fund pay less through a discount scheme.

Professor Paul Workman, of the Institute of Cancer Research, said the drug was a victim of its own success as its novel action meant it did not fit easily into the current system for assessing treatment.

He added: ‘Abiraterone, which was discovered and developed here at the Institute of Cancer Research, is now used as standard after chemotherapy and has extended the lives of thousands of men in the UK with advanced prostate cancer.

Last year, abiraterone was used before chemotherapy by 3,000 men in England

‘The decision to refuse use of abiraterone before chemotherapy will deny many thousands of men the opportunity to access the drug earlier in their course of treatment.

‘It is a particular blow for men who are unable to have chemotherapy because they are too old or too frail, since they could now miss out on abiraterone too.’

Professor Peter Johnson, Cancer Research UK’s chief clinician, said the plan did not make sense, adding: ‘Nice has previously agreed that abiraterone is an effective and cost-effective drug for men with prostate cancer who have already had docetaxel (chemo), and there is no reason for it to be any less effective before the chemotherapy – if anything, the reverse.’

Mikis Euripides, of the charity Prostate Cancer UK, described the draft guidance as a ‘huge blow’ for men with advanced disease.



‘It seems unforgivable that such a powerful and beneficial treatment should be left tantalisingly out of reach,’ he said.

‘We implore Janssen and Nice to work together to do everything in their power to make this vital treatment available as soon as possible for all in England and Wales who need it.’

Sir Andrew said: ‘We hope that during this consultation, the manufacturer uses this opportunity to look again at its submission and provides the committee with additional information which may enable them to reconsider.’

Janssen said it was disappointed, but would ‘work constructively’ with Nice.