Thousands of men with prostate cancer are being “condemned to die” because the NHS in England is refusing to pay for a cheap drug, charities say.
About 8,400 men with high-risk prostate cancer would benefit from abiraterone, a drug which reduces the risk of cancer returning by 50 per cent and improves survival rates by 40 per cent.
The drug costs less than £2.50 per day, but NHS England said it did not have the budget to pay for it, even though abiraterone is available to patients in Scotland and Wales.
Prostate Cancer UK said 13 men a week died avoidably as a result of the “bureaucratic quagmire” over NHS budgets. The charity urged Wes Streeting, the health secretary, to intervene.
Abiraterone blocks the production of testosterone, a hormone which fuels prostate tumours. The drug was made available on the NHS in 2012 as a life-extending treatment for men with incurable aggressive prostate cancer that had already spread.
A major trial in 2022 revealed it could also stop the disease progressing in men with aggressive prostate cancer that had not yet spread, who had it diagnosed at an earlier stage. The trial showed it would save 672 lives a year if the NHS made it available for this cohort of 8,400 men each year. Research also suggests abiraterone would save the NHS £5,000 a year per patient by reducing treatment costs associated with the cancer spreading.
But because the drug is off patent, meaning generic versions can be made cheaply, the NHS has a complicated process for approving it and claims it cannot afford to roll it out.
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Amy Rylance, of Prostate Cancer UK, said “bureaucratic blockages” were holding up approval of the drug, which was “stuck in no man’s land, where everybody seems to say it’s somebody else’s fault”.
Turner said he was livid that men unable to afford abiraterone would die as a result of a “bureaucratic nightmare”
GILES TURNER
She said: “In the two years that England has delayed making this decision, over 1,300 men have been condemned to die from prostate cancer. Some 13 men a week are dying from a cancer that could have been easily and cheaply cured. Abiraterone costs £2.37 a day. In these really high risk men, it is curative. It is saving these men’s lives. It’s preventing their cancer from coming back.”
Rylance said one of the most frustrating aspects was that the Stampede trial, which proved abiraterone saved lives, was held in England. “Other parts of the world are taking our science and applying it, and we’re not,” she said.
Nick James, of the Institute of Cancer Research, London, said the drug had been discovered there and “ trialled across England, but English men are the ones missing out now”.
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“Following the expiry of the abiraterone patent in October 2022, the cost of this life-extending drug has reduced dramatically,” he said. “Previously costing around £3,000 per month, the availability of generic versions means the price has dropped to around £77 per pack.
“Those living in Scotland and Wales can receive the treatment free. But the NHS in England has previously decided that it would be too expensive to offer the drug, and its guidance has not changed since the price of the drug has been slashed.
“It’s a ludicrous situation and NHS England needs to get a grip of it now, in order to ensure the men who need this life-extending drug can access it.”
Men in England can pay for abiraterone privately and some have emptied their life savings to do so, knowing it will “help keep them alive”.
Keith ter Braak, 81, had prostate cancer diagnosed in 2019 and has spent about £80,000 on obtaining abiraterone privately. “I wanted to use those savings for me and my wife and our old age. If I was living in Scotland or Wales I would get it free. Abiraterone is keeping me alive, it stops the production of testosterone which is fuel for my cancer. It is such a stupid false economy for the NHS to not give it to us to stop the cancer spreading — they are the ones who will have to pay to treat us if the cancer spreads.”
Giles Turner, 65, a retired banker in Sussex, has spent £20,000 on abiraterone since he had high-risk prostate cancer diagnosed in March 2023. “The treatment has been successful. I am in remission,” he said. “I’m very lucky that I can afford it.
“But I’m livid that there are thousands more men who should be on this treatment who are not, and some of them will die as a result. Men’s lives are being caught up in a bureaucratic nightmare. The government needs to take responsibility and sort it out.”
Prostate cancer is the most common cancer in men and there are 56,000 cases and 12,000 deaths each year in the UK.
NHS England said: “Expanding access to abiraterone for this particular type of prostate cancer was identified as one of the top priorities following a clinically-led review. But the NHS can only offer this treatment once the necessary recurrent funding is available, and this is being kept under active review.”