Commenting on today’s rejection of abiraterone before chemotherapy in final draft guidance from NICE, Professor Paul Workman, Interim Chief Executive of The Institute of Cancer Research, London, said:
“We’re very disappointed that men with prostate cancer will miss out on the chance to have abiraterone much earlier in their course of treatment as a consequence of this decision. There is clear evidence that use of abiraterone before chemotherapy is beneficial for patients, and gives them longer, healthier lives. We urge NICE and the drug’s manufacturer to get back to the table, and explore every option for making abiraterone available to these men at a price that is affordable for the NHS.
“Abiraterone, which was discovered at The Institute of Cancer Research, is now used as standard after chemotherapy, where it was found to be cost-effective under NICE’s own end-of-life criteria. It is plainly illogical that NICE did not have the flexibility to assess use of abiraterone before chemotherapy under the same end-of-life criteria, simply because men were here surviving for longer than the two-year cut-off. It is an unintended, and quite bizarre, consequence of the current rules for appraisals that patients have to wait until their life expectancy drops before they can access beneficial drugs on the NHS.
“Abiraterone maintains patients in a better state of health during the course of treatment than chemotherapy, and the increases in median survival it offers include much larger benefits for life expectancy in some men. Now men will have to wait until they are in the final stage of their lives before they can access this treatment, and men who are too frail to receive chemotherapy face not being able to receive abiraterone at all.
“It is critical that patients are able to benefit from innovative new treatments that make use of the latest genetic and molecular advances in cancer. We believe that the current NICE system for drug appraisals takes too little account of how innovative a treatment is, and we worry that the new rules under consideration could make this situation even worse. It is likely that many modern targeted therapies will be more effective in patients when used earlier in treatment or in combinations, but it will be impossible to provide treatment in these ways if innovative drugs first fail to clear the hurdle of NICE approval.
“It is also concerning that the willingness of the Cancer Drugs Fund to cover the full cost of some new treatments in England may be damaging the ability for drugs to be approved and made available across the UK, or to secure long-term access to these treatments once the Fund comes to an end.”
Notes to editors
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