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‘U-turn’ on prostate cancer drug

The National Institute for Health and Care Excellence (NICE) has been accused of “playing fast and loose” with the lives of cancer sufferers following the announcement that thousands of men with prostate cancer could be denied life-extending treatment following a U-turn by the NHS rationing body.
Each year more than 40,000 British men are diagnosed with prostate cancer. More than 10,000 develop an advanced form of the disease which resists standard hormone treatment and chemotherapy and most will die within five years, making the disease the second most common cause of cancer death in men.
Trials found that the drug Xtandi® on average gave patients an extra five months of life – bringing their survival to 18 months. Three months ago NICE ruled that the drug would be made available to those with cancer which has spread beyond the prostate, and stopped responding to treatment, after the manufacturers agreed a discount on the £25,000 per patient price. But the watchdog has now issued new restrictions, which mean that the NHS will only fund the drug if men have not tried the only other drug available for such cases.
Owen Sharp, Chief Executive at Prostate Cancer UK, said Nice had acted in secrecy, and had given no explanation for a “blatant U-turn” which will cost lives. He said, “Nice is playing fast and loose with men with prostate cancer in the advanced stages of the disease who may become resistant to other treatments, and what’s worse without saying why.”
Last week Prof David Haslam, the chairman of Nice, said British patients should be more assertive in ensuring that they obtain drugs which the watchdog has backed, and learn from the attitudes of Americans, who were more likely to see themselves as equal partners with their doctors
Nice said it changed its recommendation because of responses to its consultation, and because trials on Xtandi® did not include patients who had previously received the standard treatment of abiraterone, leaving them unable to draw conclusions about its effectiveness in such cases.


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