NHS England has announced an expansion of access to abiraterone, a drug used in the treatment of prostate cancer, making it available to thousands more men. The drug, which deprives cancer cells of hormones necessary for growth, will now be offered to high-risk patients whose cancer has not yet spread beyond the prostate. This decision follows a period where broader access was available in Scotland and Wales but not in England and Northern Ireland.
Expanded Eligibility
Previously, abiraterone was primarily restricted in England to patients with advanced, metastasized prostate cancer. Under the new guidelines, patients with a new diagnosis of prostate cancer that remains localized to the prostate, particularly those considered high-risk, will be eligible. This expanded access is expected to be implemented within weeks, with approximately 2,000 men diagnosed in the last three months potentially gaining access initially.
Impact Estimates
Various organizations have provided estimates regarding the impact of this expansion:
- Prostate Cancer UK estimates that approximately 7,000 men annually will begin this treatment. The charity projects this could prevent cancer progression for 1,470 individuals and save an estimated 560 lives.
- The NHS estimates that around 8,000 men will become eligible for the drug each year, potentially reducing prostate cancer deaths within this group from approximately 1,900 to fewer than 1,000.
- Prostate Cancer UK further estimates that the decision could prevent over 3,000 deaths within the next five years.
Prostate cancer is the most common cancer among men in the UK, with approximately 55,300 new diagnoses and 12,200 deaths reported annually. An estimated one in eight men are affected by the disease.
Clinical Evidence and Administration
The expanded use of abiraterone is supported by findings from clinical trials. The STAMPEDE trial, published in 2022, demonstrated improved survival rates for men receiving abiraterone in conjunction with standard care. Further research, including a clinical trial led by University College London and the Institute of Cancer Research, indicated that two years of abiraterone treatment could halve the risk of prostate cancer recurrence and reduce the risk of death by 40% when the disease is localized.
Abiraterone will be administered alongside prednisolone, a steroid, and other standard treatments, including androgen deprivation therapy (ADT) and radiotherapy.
Background and Funding
Abiraterone became a generic medicine in October 2022 following the expiration of its patent. This change reduced financial incentives for pharmaceutical companies to seek approval for its use in a broader patient group. While Scotland and Wales had implemented protocols to supply the drug through their National Health Service systems since 2023, a similar change in England had not occurred until this recent announcement.
The decision by NHS England to broaden access was supported by organizations such as Prostate Cancer UK and followed advocacy efforts, including those by patient Giles Turner, who was diagnosed with aggressive prostate cancer in March 2023 and chose to pay for the treatment privately. NHS England stated that the funding for this expanded availability was secured through savings from other medicines.