Radium-223 now available before chemotherapy for men in England and Wales following NICE reappraisal
Men living in the two home nations with prostate cancer that's spread to the bones will now be able to access the life-enhancing treatment on the NHS if they're unable to have chemotherapy, thanks to reversal of a decision in 2015.
Radium-223 will now also be available on the NHS for men in England and Wales with hormone-resistant prostate cancer that has spread to the bones who are not suitable for chemotherapy, as well as those who have already undergone chemo. Today's decision by the National Institute for Health and Care Excellence (NICE) is welcomed by Prostate Cancer UK after making strong criticisms of NICE's 2015 ruling that radium-223 only be offered after chemotherapy.
"Today’s announcement is an important victory for men whose prostate cancer has spread to the bone and are unable to have chemotherapy," says Heather Blake, our Director of Support and Influencing. "NICE’s decision means that these men will now be able to benefit from routine access to radium-223 which can often be their only viable treatment option for reducing the pain and distress caused by the cancer in their bones. It will now no longer be restricted to those men who have already had chemotherapy."
Administered by injection, radium-223 is a mildly radioactive version of the metal radium that is taken up by active bone cells. Cancer cells are more active than normal bone cells, so are more likely to pick up the radium-223 and be killed by the radiation, with minimal damage caused to healthy cells nearby. In trials, it was shown to extend the lives of patients with this form of prostate cancer by more than three months.
After years of uncertainty, all prostate cancer treatments previously available via the Cancer Drugs Fund continue to be routinely available to at least some men in England.
NICE's reversal follows work with radium-223's manufacturer to reconsider evidence of its benefits for men unsuitable for docetaxel chemotherapy against the treatment's cost. It also means that – after years of uncertainty – all prostate cancer treatments previously available via the Cancer Drugs Fund (CDF) continue to be routinely available to at least some men in England.
"This huge milestone is the result of a recent series of amended rulings on prostate cancer drugs, which show that increased flexibility from NICE alongside willingness from industry to achieve cost-effectiveness can lead to better decisions for men," says Heather.
"Both must become a more permanent feature when considering the availability of new treatments so that we get the right decision the first time around. Without this flexibility, the new reforms to the drug appraisal process will not work for men fighting prostate cancer in the months and years to come."