NICE decision to approve radium-223 only for those men who've already had chemotherapy leaves access for men unsuitable for chemo in doubt.
The National Institute for Health and Care Excellence (NICE) have today announced their final decision to make radium-223 available on the NHS for men with hormone-resistant prostate cancer that has spread to the bones, but only if they’ve already been treated with chemotherapy.
Radium-223 is a mildly radioactive version of the metal radium. It’s given by injections into the vein, where it travels in the blood system to the bones. It works a bit like calcium, and is taken up by active bone cells. But the radioactivity then kills these cells. Cancer cells are more active than normal bone cells, so they’re more likely to pick up the radium-223. This also means that the side effects are minimal, because healthy cells aren’t damaged. This treatment specifically targets prostate cancers that have spread to the bone, and the fact that it causes minimal damage to healthy tissue makes this an important step forward.
At the moment, radium-223 is accessible to men in England on the Cancer Drugs Fund (CDF) both before and after chemotherapy, but how much longer it will be available from this source is in doubt. In September this year, the CDF announced their decision to remove radium-223 from their list of approved drugs; a decision that was appealed by Bayer, the drug’s manufacturers. We’re still waiting to hear the outcome of this appeal, but for now, radium-223 is still available on the CDF.
These restrictions around access to radium-223 don’t exist north of the border. The Scottish Medicines Consortium (SMC) has recently approved the prescription of radium-223 for men whose prostate cancer has spread to the bone whether or not they’ve been treated with chemotherapy already.
Heather Blake, Director of Support and Influencing at Prostate Cancer UK said: “Today’s decision is good news for men with advanced prostate cancer that has spread to their bones and for whom chemotherapy is no longer working. It is, however, extremely disappointing that – contrary to the recent ruling in Scotland – radium 223 has not been approved for men with this type of prostate cancer who are unable to have chemotherapy. For these men this drug is often the only viable treatment option which can offer them hope.
“A decision on whether radium 223 will remain available on the CDF is imminent, however even if it does remain on the list, this will not provide the long term solution that these men need. It is critical that NICE and the manufacturer work together to do everything they can to ensure that the treatment remains available to all the men who need it.”