Peter Ford, Dale Rominger, Rob Banner and Hugh Gunn with the NICE enzalutamide petition

What we're doing

Over the last few years breakthroughs in advanced prostate cancer treatments that can prolong and improve quality of life have been coming thick and fast. A key part of our work is to review the latest evidence from clinical trials, and to ensure that all men can access effective treatments that are right for them, no matter where they live in the UK.

We talk with people affected by prostate cancer so that we can use real life experiences to influence the UK health bodies who decide whether these drugs should be made routinely available via the NHS or HSC. Several hundred of you from across the UK have taken part in our various drug treatment surveys so far, which we use to inform our patient group submissions to the National Institute for Health and Care Excellence (NICE) and the Scottish Medicines Consortium (SMC), urging them to make these treatments available - a huge thank you to everyone who has taken part.

We also influence through public media campaigns to draw extra attention to issues of accessing treatments - whether for a particular drug, an issue with the appraisal systems, or highlighting someone’s experience of care.

In addition to campaigns on specific drugss, we’ve been: influencing the reform of drug appraisal systems, feeding into the Accelerated Access Review, and responding to consultations on issues such as the Cancer Drugs Fund in England  to make sure that men are getting access to the latest clinically effective treatments as quickly as possible. Keep an eye on our campaigns pages for the latest updates, or sign up for our newsletter.

Below are some of the drug treatments that are now available in at least one nation of the UK, some of which we are still currently pushing to be made available. We won’t stop working until the men who need them can access these treatments, no matter where they live.

If you are eligible for a treatment that has been approved for use, but you’re struggling to get access, then please contact us.

Abiraterone

Abiraterone (Zytiga®) is a type of hormone therapy for men with prostate cancer that has spread to other parts of the body (advanced prostate cancer), when other hormone treatments have stopped responding. This treatment may help some men to live longer, and can also help control symptoms.

Abiraterone was originally proven to be effective for use after chemotherapy. There is now evidence which shows that abiraterone given to men earlier in the treatment pathway - so to those men who have not, or will not, have chemotherapy - can also be effective.

Abiraterone is now available UK-wide after chemotherapy. After recent decisions by the National Institute for Health and Care Excellence (NICE), this drug should be routinely available without the need for chemotherapy no later than June 2016, and we will be following up in each UK country to make sure that this is the case.

Abiraterone after chemotherapy

  • In England: approved by NICE in June 2012and is now routinely available on the NHS. However, you won’t be able to have abiraterone if you’ve already had enzalutamide – unless you had to stop taking enzalutamide within three months because of severe side effects or because your cancer continued to grow.
  • In Scotland: approved by the Scottish Medicines Consortium (SMC) in August 2012 (without restriction with regards to previous use of enzalutamide.)
  • In Wales: approved by the All Wales Medicines Strategy Group (AWMSG) in February 2012 (without restriction with regards to previous use of enzalutamide). The AWMSG guidance was superseded by the NICE guidance in June 2012.
  • In Northern Ireland: approved by the Department of Health following the NICE recommendation in June 2012.

Earlier abiraterone (without chemotherapy)

  • In England: approved by NICE in March 2016 and should be routinely available to eligible men by June 2016.
  • In Scotland: approved by SMC in October 2015 and is now routinely available on the NHS.
  • In Wales: originally denied by AWMSG, but will follow the NICE ruling of March 2016, and should be routinely available to eligible men by June 2016.
  • In Northern Ireland: decision yet to be announced by the Department of Health, but we would expect this would follow the NICE ruling of March 2016, and be available to men by July 2016.

 

Enzalutamide

Enzalutamide is a type of hormone therapy for men whose prostate cancer has spread to other parts of the body (advanced prostate cancer) and has stopped responding to other hormone therapy treatments. It may help some men to live longer. It can also help control symptoms.

Enzalutamide was originally proven to be effective for use after chemotherapy. There is now evidence which shows that enzalutamide given to men earlier in the treatment pathway - so to those men who have not, or will not, have chemotherapy - can also be effective.

Enzalutamide is now available UK-wide after chemotherapy. After the recent decision by the Scottish Medicines Consortium (SMC), this drug should be routinely available without the need for chemotherapy no later than June 2016. We will be following up in each UK country to make sure that this is the case.

Enzalutamide after chemotherapy

  • In England: approved by NICE in May 2014. However, you won’t be able to have enzalutamide if you’ve already had abiraterone – unless you had to stop taking abiraterone within three months because of severe side effects or because your cancer continued to grow.
  • In Scotland: approved by SMC in November 2013.
  • In Wales: approved by AWMSG, with Wales following NICE guidance. Men may not be able to access enzalutamide if they have already had abiraterone.
  • In Northern Ireland: approved with the NI Department of Health following NICE guidance. Men may not be able to access enzalutamide if they have already had abiraterone.

Earlier enzalutamide (without chemotherapy)

 

Radium-223

Radium-223 (Xofigo®) is a drug for men with prostate cancer that has spread to the bones and has stopped responding to hormone therapy.

Radium-223 delays bone symptoms of advanced cancer, such as bone fractures, and can reduce bone pain. It may also help men live longer. In a recent clinical trial, men who received radium-223 at the same time as their usual treatments lived about four months longer than men who took a placebo.

Radium-223 after chemotherapy

Earlier Radium-223 (without chemotherapy)

  • In England:  not currently approved for routine use on NHS England, however it is available through the Cancer Drugs Fund until 1 July 2016. We are currently putting together a patient group submission around the benefits of using radium-223 at this stage in treatment, and will be submitting to NICE. We’ll keep you updated on our progress.
  • In Scotland: approved by SMC in October 2015.
  • In Wales: not currently available. We are working with NICE to try and get this drug approved for this use as soon as possible, and this guidance should then be followed in Wales.
  • In Northern Ireland:  not currently available. We are working to try and get this drug approved for this use as soon as possible.

Cabazitaxel

Cabazitaxel (Jevtana®) is a new type of chemotherapy. It can’t cure prostate cancer, but it may help men to live longer. It can also help control or delay symptoms.

Cabazitaxel is suitable for men whose prostate cancer has spread to other parts of the body (advanced prostate cancer) and has stopped responding to hormone therapy and the chemotherapy drug docetaxel (Taxotere®).

Read our information about getting new treatments for more on how to get treatments that are licensed but aren’t available on the NHS or HSC. For more information on cabazitaxel, speak to your doctor or nurse, or call our Specialist Nurses.

  • In England: NICE have recommended cabazitaxel for use on the NHS as of April 2016. This treatment should be available to you if you are eligible. 
  • In Scotland: The SMC rejected cabazitaxel for routine use on NHS Scotland in June 2016. We have encouraged manufacturers and the SMC to negotiate on price in order to get this treatment approved. We’ll update with further news as it becomes available.
  • In Wales: NICE have recommended cabazitaxel for use as of April 2016. The All Wales Medicines Strategy Group follow NICE guidance, but it may take up to three months for this drug to become routinely available.
  • In Northern Ireland: Currently being appraised by the Department of Health. We'll update this page once the recommendation is announced.

Earlier docetaxel chemotherapy

In 2015 the STAMPEDE trial reported that men with metastatic prostate cancer (cancer that has spread to other parts of the body) who were taking docetaxel chemotherapy at the same time as hormone therapy lived for an average of 15 months longer than those taking hormone therapy alone. This is a real game changer in the battle against prostate cancer, and Prostate Cancer UK has been working to speed up the process of ensuring that men who need this treatment can get it.

The patent for docetaxel has expired, which means that any pharmaceutical company is free to make and sell the drug. This means that, unlike when a new drug is licensed, there is no commercial incentive for any company to push upfront docetaxel through the usual approval processes (such as NICE and the SMC) to make hospitals provide it. In the absence of a clear-cut pathway to access, we worked closely with researchers, health professionals and commissioners to get things moving.

This issue of accessing off-patent medicines, or repurposing existing medicines for new uses, is one that we’re looking at longer term. We supported the Off-patent Drugs Bill, which was intended to overcome these challenges, as well the Accelerated Access Review, and current review of access to new medicines in Scotland. We’ll update you on this work as it progresses.

If you are eligible for this treatment, but you’re struggling to get access, then please contact us.

  • In England
    Following pressure from ourselves and evidence provided by researchers on the STAMPEDE trial, NHS England put earlier docetaxel through a rapid evidence review. In January 2016, NHS England informed their Specialised Commissioning Hubs that this treatment can now be prescribed for men who may benefit.
    However, this sort of approval is not legally binding, unlike decisions made by NICE, and so it’s key that men know that they are eligible for this treatment, and that all relevant healthcare professionals know about the potential benefits and that it can now be prescribed. We contacted 1,202 oncologists and 1,563 Specialist Nurses in England to make sure that they knew that this was the case, as well as trying to spread the word via the media and online.
  • In Scotland
    First Minister Nicola Sturgeon took a personal interest in 2015 when it was reported to her on Twitter that men in the west of Scotland were getting earlier access to docetaxel, but not those elsewhere in the country. We wrote to the FM in August 2015 urging her to ensure the access was replicated across Scotland, as well as discussing the situation with the government’s Head of Medicines. Earlier docetaxel should now be available for all eligible men in Scotland, but please do get in touch with us if you are eligible for this treatment and struggling to get access, so that we can offer support.
  • In Wales
    After talking to men and clinicians in Wales we knew that access to earlier docetaxel was patchy. We launched a successful campaign in order to make sure that all eligible men were able to access this treatment if it may benefit them. Earlier docetaxel should now be available for all men in Wales who meet the criteria. Please get in touch with us if you are eligible for this treatment but struggling to get access, so that we can offer support.
  • In Northern Ireland
    We know from talking to clinicians in Northern Ireland that some men are already getting access to earlier docetaxel, however we’re concerned that this is not routinely available across the country yet. We are talking to health officials about the process for reviewing earlier docetaxel, and will continue to do whatever is needed until all eligible men can access this treatment as soon as possible.

 

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