Getting new treatments

This page explains why new treatments for prostate cancer aren’t always widely available in the UK. It also explains how you can apply to get a new treatment if it’s not available on the NHS (in England, Scotland or Wales) or through the Health and Social Care (HSC) service in Northern Ireland.

This page only includes information on medicines for prostate cancer. It doesn’t include information on other new treatments, such as new types of surgery.

How can I get new treatments?

Once a new medicine for prostate cancer has been licensed in the UK, doctors are allowed to prescribe it for men who they think will benefit from the treatment.

But your local hospital is unlikely to routinely offer the treatment for free on the NHS (or through the HSC in Northern Ireland) until it has been recommended for use. Who makes this decision, and how you can access new treatments, will vary depending on where you live in the UK. You may also be able to get a new treatment by taking part in a clinical trial.

Where do you live?

England

In England, the National Institute for Health and Care Excellence (NICE) decides whether a new treatment should be made available on the NHS.

NICE weighs up the evidence on how well a treatment works and how much it costs. It then recommends whether or not the treatment should be available on the NHS in England. It takes several months for NICE to reach a decision.

If a treatment is recommended by NICE and it’s suitable for you, your hospital legally has to provide it for you.

Can I get a medicine on the NHS before NICE has recommended it?

Usually, hospitals won’t make a licensed medicine available on the NHS before it is recommended by NICE. But your doctor may still be able to get it for you by applying to the Cancer Drugs Fund (CDF).

What is the Cancer Drugs Fund?

The Cancer Drugs Fund is money the English government has put aside to pay for some cancer drugs in England. These are drugs that have not been approved by NICE and are not available on the NHS. The fund covers:

  • medicines that NICE has not yet looked at
  • medicines that NICE is currently looking at
  • medicines that NICE has looked at and said do not work well enough, or are very expensive when compared to the amount of benefit they might give men
  • medicines that NICE has looked at, but has only recommended for a very specific group of patients.

The aim of the fund is to allow people with cancer to get the medicines that doctors think will help them. It’s only available in England.

How does the Cancer Drugs Fund work?

There’s a list of medicines, called a priority list, that are available through the Cancer Drugs Fund. There are usually guidelines about who each medicine is suitable for. For example, the guidelines might say which treatments you need to have already had before getting a drug on the list.

If your doctor thinks a medicine on the priority list is suitable for you and you want to have it, they need to apply for it for you. You cannot apply directly yourself.

Abiraterone and enzalutamide before chemotherapy, cabazitaxel and radium-223 are all on the priority list. This means that if one of these is suitable for you, it is likely that you will be able to have it.

You should get a decision about whether you can have the drug within 31 days. But it’s often sooner than this. If the decision is no, you will be given clear reasons why. Your doctor can appeal against the decision if they believe important information has been overlooked, or if your condition changes.

Ask your doctor for more information about the Cancer Drugs Fund. You can also get more detailed information from Cancer Research UK.

Scotland

In Scotland, the Scottish Medicines Consortium (SMC) weighs up the evidence on how well a treatment works and how much it costs, and recommends whether it should be available on the NHS – a bit like NICE does for England. If the SMC approves a treatment, health boards in Scotland usually follow the guidance and make the treatment available on the NHS – but they don’t have to.

If your doctor thinks a new treatment is suitable for you but it’s not available on the NHS – because the SMC hasn’t approved it, or hasn’t looked at it yet – they can make a special request to your health board for you to have it. You may hear this called the Peer Approved Clinical System (PACS). Ask your doctor for more information.

 

Wales

If you live in Wales, the All Wales Medicine Strategy Group (AWMSG) decides whether or not to fund a drug – but only until NICE makes its decision. After that, the AWMSG must follow NICE's guidance.

If your doctor thinks a new treatment that’s not available on the NHS is suitable for you, they can apply to your Local Health Board for you to have it. You may hear this called an individual patient funding request. Ask your doctor for more information.

Northern Ireland

In Northern Ireland, the Northern Ireland Department of Health has one month to consider new NICE decisions and decide if treatments should be available for free in Northern Ireland. But it doesn't have to follow NICE's recommendations.

If your doctor thinks a new medicine is suitable for you but it’s not available on the Health and Social Care (HSC) service in Northern Ireland, they can apply to your local HSC Trust for you. You may hear this called an individual funding request. Ask your doctor for more information.

References

Updated: March 2015

  • Full list of references used to produce this page  

    NHS England. National Cancer Drugs Fund list Ver 4.2. 2015