The Institute of Cancer Research is calling on the Scottish Medicines Consortium to reconsider its decision to bar patients with prostate cancer from access to Janssen’s Zytiga (abiraterone) before they have had chemotherapy.

The cost watchdog said this week it would not endorse the drug’s use earlier in the treatment pathway, despite the fact that patient groups and clinicians who participated in the process “spoke strongly about the improved quality of life it offers men in the early stages of prostate cancer”. 

Zytiga is recommended as an option in Scotland for treating patients post chemotherapy, but the Committee felt there was “insufficient evidence” on the overall benefits of its use at an earlier stage. Also, while a confidential discount to NHS Scotland under a Patient Access Scheme has been agreed, the drug’s cost is “still substantial,” the SMC said. 

But the ICR, which discovered the drug, insists there is “clear and growing evidence” that use of Zytiga in this setting is beneficial for patients. It argues that the SMC appraisal itself acknowledges data showing that the drug extends life by an average of more than four months when given before chemotherapy, but failed to include these findings in the cost analysis.

Janssen said it is disappointed with the decision, which echos a rejection by the National Institute for Health and Care Excellence in August last year, but said it would work closely with the SMC in the hope of agreeing a way to make Zytiga routinely available in Scotland for pre-chemo patients.

On a positive note...

Meanwhile, the SMC said patients in Scotland would get routine access to four new medicines: Celgene’s Abraxane (paclitaxel albumin) for pancreatic cancer; Pfizer’s Bosulif (bosutinib) for chronic myelogenous leukaemia; GlaxoSmithKline’s Anoro (umeclidinium/vilanterol) for chronic obstructive pulmonary disease; and Finox Biotec’s biosimilar Bemfola (follitropin alfa) to treat female infertility and hypogonadism in men.

Abraxane and Bosulif were accepted after consideration under the SMC’s more flexible PACE (Patient and Clinician Engagement) process, which aims to improve patient access to new medicines for the treatment of end of life and very rare conditions, it was noted.