Men denied life-extending prostate cancer drug on NHS in England

A cancer charity has said it is “angry and frustrated” that ministers and health officials have not approved the provision of a life-extending prostate cancer drug through the NHS in England.

The drug, abiraterone, has been available in Scotland and Wales for two years for high-risk patients whose cancer has not yet spread, but not in England and Northern Ireland.

In a letter to Prostate Cancer UK, seen by the BBC, Health Minister Karin Smyth said the decision by NHS England, following a lengthy review, was “based on overall affordability” and that “it would not be appropriate to intervene”.

The government said urgent advice had been requested on the issue.

The charity said it was a “dire and urgent situation in England” with “a bureaucratic blockage denying men this treatment”.

A Department of Health and Social Care spokesperson said: “We understand the frustration and upset of some patients who cannot access this potentially life-saving treatment. Ministers have requested urgent advice on the issue.”

Although not a cure, abiraterone can help stop prostate cancer spreading to other parts of the body.

In England and Northern Ireland, the drug is only approved for men with very advanced prostate cancer which has spread already.

In Wales and Scotland, people with the disease that has not yet spread can also get it.

Research has shown that for these earlier stage patients, the survival rate after six years is improved and that the drug halved the rate of progression of the cancer.

The charity says many lives could be extended by the drug, given the findings from a trial called Stampede, published in 2022.

It found improved odds of survival among men given the drug alongside usual care, and concluded that abiraterone should be considered a new standard treatment.

According to figures from NHS England, each year about 8,400 patients have high-risk prostate cancer that has not yet spread.

Using the Stampede assumptions, 672 of those men could die prematurely without access to abiraterone.

In October 2023, BBC News spoke to Giles Turner, a retired banker living in Sussex. He was diagnosed with prostate cancer earlier that year but was told that abiraterone could not be obtained on the NHS in England.

He chose to pay for treatment with the drug at £250 a month. He told us then that he felt “very fortunate” to be able to afford it, but outraged for others who could not.

At the time, NHS England said it was reviewing the drug’s use for a wider range of men.

However, in December 2024 it told Prostate Cancer UK that “it has not been possible to identify the necessary recurrent headroom in revenue budgets”.

Because abiraterone is a generic drug which has gone “off patent” and is licensed for only one group of prostate cancer patients, there is a complicated process to get it approved for wider use.

Each year, NHS England can make “discretionary” investment decisions with a specialist advisory group, but it has chosen not to for this drug.

Smyth’s letter earlier this month said the process had to look at “the overall budget impact of introducing a new treatment based on patient volumes”, and ministers would not intervene.

Mr Turner said he was “stunned” that nearly one-and-a-half years after the BBC report, NHS England had not caught up with NHS Scotland and NHS Wales.

He has spent £20,000 so far on his treatment, and said he felt it was wrong that while expensive new patented drugs treatments could be funded, abiraterone – costing the NHS £77 per pack per month – could not be.