NHS limits use of life-prolonging prostate cancer drug enzalutamide


  • Patients who have already had abiraterone will not get enzalutamide
  • It can prolong life by at least five months when other treatments have failed
  • Patients in Scotland will have access to the drug with no restrictions

By
Jenny Hope

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Thousands of men with advanced prostate cancer are to miss out on a life-extending drug because of new NHS restrictions.

Enzalutamide prolongs life by at least five months in men who have run out of treatment options – with some surviving more than 18 months.

But health chiefs in England are issuing guidance which will stop it being prescribed to patients who have already received a different new drug called abiraterone.

Restricted: Enzalutamide prolongs life by at least five months in men who have run out of treatment options

In effect, guidance from NHS England means men with advanced prostate cancer will only be able to get one of the two drugs – which British scientists helped to develop – on the NHS.

Around 10,500 British men have advanced prostate cancer that has become resistant to standard hormone treatments.

Up to 3,000 a year would benefit from the new drugs, which have been offered in turn to many patients either before or after chemotherapy in recent months.

The Cancer Drugs Fund and the NHS have funded the drugs until now, while awaiting a decision from the National Institute for Health and Care Excellence (Nice) on whether enzalutamide should be routinely funded.

It was initially recommended for NHS funding last October, but Nice proposed in January that it should be banned for men in England and Wales previously treated with abiraterone.

Men in Scotland are getting it without restrictions.

The outcry over the plan led to Prostate Cancer UK spearheading a campaign, with over 13,500 people signing its petition.

The protest had widespread support from high profile figures such as Sir Michael Parkinson and other organisations such as Tackle Prostate Cancer.

Nice then performed another U-turn in April which seemed to go back to its original position of recommending enzalutamide regardless of a patient’s previous treatment.

However, guidance from Nice today (wed) merely says there is not enough evidence to make a recommendation about how the two drugs should be used.

NHS England, the body which advises local area cancer teams on which drugs to fund, says as a result of the lack of evidence patients who have been treated with abiraterone cannot have enzalutamide.

It goes further, saying men who have received enzalutamide cannot then have the other drug – effectively restricting patients to only one drug during their treatment.

Lethal: A scanning electron microscope image of human prostate cancer cells

Ian and Jackie Fitch are now selling
their possessions to raise money for enzalutamide to treat him. Mrs
Fitch said: ‘It’s just cruel and wrong.

‘Our
life is lived from one consultant appointment to the next, there’s no
dignity and now the NHS has snatched away the last hope for us both.’

Our life is lived from one consultant
appointment to the next, there’s no dignity and now the NHS has
snatched away the last hope for us both…

The drug, a pill called Xtandi which is taken at home, costs around £25,000 for an average course of treatment.

But the manufacturer Astellas Pharma has reduced the price through a patient access scheme which makes it cost effective, say Nice.

Owen Sharp, Chief Executive of Prostate Cancer UK, said it had received notification of NHS England’s intended guidance.

He said ‘We are extremely disappointed that NHS England has interpreted NICE’s guidance to mean that they are not obliged to fund enzalutamide for men who have had abiraterone.

‘We have heard many heartbreaking stories of men and their families  now left with nowhere to turn, with some resorting to raiding  their savings or fundraising to pay for enzalutamide privately.

‘The system has given with one hand and taken with another, cruelly snatching away once again a last hope of extra time with loved ones. 

‘As these drugs are both relatively new there is not currently a huge volume of evidence to prove the efficacy of sequential use. ‘However in this situation the default position should not be to deny access.

‘Doctors should be enabled to prescribe whichever drugs they feel clinically appropriate and learn from the outcome, without having to worry that their decision may mean another door is closed further down the line.’

Comments (16)

what you think

The comments below have not been moderated.

Steve,

Cheshire, United Kingdom,

26 minutes ago

Thank you Prime Minister.

Razorwire,

England_my England, United Kingdom,

27 minutes ago

Funnel the money used to give free boob jobs to people like the £1k a day escort who had children with no father(s) to more worthy causes like this.

bobtail,

cumbria, United Kingdom,

39 minutes ago

Do unto others as you would have done unto you.Then they would give out the drugs

J W,

Yeovil, United Kingdom,

39 minutes ago

But the NHS has money to support the birth of anyone from around the world. Come on – where are the priorities for the UK?

Geo,

Glasgow, United Kingdom,

1 hour ago

What price a human life eh?

anoyed 1,

truro,

2 hours ago

what right do the government have to play judge and jury like this over peoples lives

Ubique,

London,

2 hours ago

If this was a drug for breast cancer there would be no problem in NICE and NHS England approving it! Men are second class citizens who are treated with contempt.

Simon,

Long Eaton, United Kingdom,

3 hours ago

I know this will get lots of red arrows, but it doesn’t cure the cancer. The end result is the same with or without the drug. Personally i’d rather go quickly rather than have it drawn out over many months knowing i’ll be dead in the end anyway. I’m sure the £75million pounds that the drug costs would be far better spent on finding a cure or prevention for prostate cancer. That would eventually benefit far more people.

Steve UK taxpayer,

hope not EU much longer, United Kingdom,

53 minutes ago

Just your opinion, others should be given the opportunity to have the drug.

mikeoh,

STOCKPORT,

45 minutes ago

Food extends life, but doesn’t cure it. Think Simple Simon. Wait till it’s your life on the line.

TopSod,

Neverland,

3 hours ago

Once again, we can’t afford to look after our own

Anon2015,

Interweb, United Kingdom,

3 hours ago

Cannabis oil – please people it’s the only non toxic cancer curing thing out there. U can grow ur own and heal yourselves!!

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