Drug companies and NICE must put differences aside and think of the men and families at the centre of this.

Man dispensing pills drugs
27 Jan 2021

We are extremely concerned that The National Institute for Health and Care Excellence (NICE) is once again on the brink of rejecting abiraterone as a first-line treatment for men with high-risk advanced prostate cancer.

Are you having hormone therapy?

  • For now, men can be reassured that NHS England has made enzalutamide, a treatment similar to abiraterone, temporarily available during the Covid-19 pandemic, due to the increased risk posed to the immune system by chemotherapy.  
  • Abiraterone has also been made temporarily available to men in Wales and Northern Ireland for the very same reason.

Abiraterone acetate (Zytiga®) is a type of hormone therapy for men with advanced prostate cancer that has spread to other parts of the body. It won’t cure prostate cancer but it can help keep it under control and has been shown to help some men live longer.  

76-year-old Robert Horsley is living with advanced prostate cancer and currently taking abiraterone. Over the last year Robert has helped us campaign for its availability for other men like him who don’t have chemotherapy because of age related frailty or other conditions.

“I have a wife, children and grandchildren and wish to remain a part of their lives for as long as possible.” says Robert. “Rejecting the use of abiraterone for men who cannot have chemotherapy, like myself, could affect them severely both mentally and physically. I believe abiraterone should be available to all those in a similar position to myself. The current global pandemic has brought about greater use of my proven treatment and this should be allowed to continue.”

“I have a wife, children and grandchildren and wish to remain a part of their lives for as long as possible.”

- Robert Horsley

 

This decision by NICE comes three months after we led a successful appeal against their initial rejection of this drug in June 2020. We showed how critical this treatment is for men who are unable to tolerate docetaxel chemotherapy, but NICE intend to reject it again for men in England, Wales, and Northern Ireland. Meanwhile, in Scotland, the Scottish Medicine Consortium approved its use for these men back in January 2020.

Both enzalutamide and abiraterone have been shown to be just as effective as chemotherapy at extending life. And thanks to policy work supported by you they’re currently available across the UK as a safer, but just as effective option as chemotherapy during the pandemic, due to the increased risk posed to the immune system by chemotherapy. As both treatments will be withdrawn once the pandemic is over, it’s vital we make sure abiraterone is available long-term for men without other options.

No man should miss out on additional months of life simply because he is unable to have chemotherapy, because of his age, other health conditions or where he lives. That’s why we’re urging NICE to reconsider their demands - for evidence that is impossible to collect - to prove this treatment works.

We also urge the manufacturer to think of the men at the heart of this struggle and finally price this treatment at a cost the NHS can afford. They must work collaboratively with NICE and NHS England to make it permanently available for men like Robert.

Why can’t NICE and this drug company come to an agreement? The key points:

  • Docetaxel chemotherapy is the standard of care for men with newly diagnosed metastatic prostate cancer. It's off patent which means it's very cheap and any new treatments for the same stage of the disease therefore have to be priced very low to be 'cost-effective'
  • Drug companies can't match this low price, so they aim to make their treatments available to a smaller group of men that are unable to have chemotherapy - these men tend to be older and are likely frail with other conditions.
  • NICE wants to know the specific benefit of their treatments to this smaller group of men before they consider commissioning, but there's no specific evidence available - if they don't change this evidence request, neither abiraterone nor any of the other treatments in this space - like apalutamide and enzalutamide - will get through either.
  • This decision could also have implications for the approval of similar treatments down the line, preventing other life-extending drugs from reaching these men in the future.

We estimate that up to 4,300 men unsuitable for chemotherapy could have already missed out on abiraterone in the two years it has taken NICE to appraise this treatment, potentially costing each man around 15 months of additional life. 

This drawn-out process has already cost up to 4,300 men precious additional time with their loved ones.

- Heather Blake, Director of support and Influencing at Prostate Cancer UK

 

Heather Blake, our Director of Support and Influencing said, “today, we call on NICE and the manufacturer to come together, put their differences aside and work flexibly for a positive outcome that puts men first. This drawn-out process has already cost up to 4,300 men precious additional time with their loved ones. Failure to come to a solution will set a precedent which could prevent other life-extending drugs from reaching the many thousands of men unsuitable for chemotherapy in the future.”

With your support we’ll continue to fight to make sure no man misses out on time with their loved ones because of their age, their health conditions or where they live. Men, we are with you.

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