Janssen’s new treatment for prostate cancer has been given the green light in Wales after a thumbs up from the All Wales Medicines Strategy Group. Zytiga (abiraterone acetate), which was discovered in the UK, has been approved for men with advanced castration resistant prostate cancer - a condition that historically has had few treatment options. In contrast, patients in England will have to continue to apply to the Cancer Drugs Fund to gain access to the drug after the National Institute for health and Clinical Excellence earlier this month said Janssen had set the price too high.
Prostate cancer is the second most common cause of cancer death in the UK, with more than 10,000 men dying every year from the disease. Around 20%-30% of those diagnosed with primary prostate cancer will present with incurable metastatic disease.
Commenting on the decision, Professor John Wagstaff, Personal Professor & Clinical Senior Lecturer in Oncology, Swansea University College of Medicine, said: “In my experience of using abiraterone acetate in the clinical trials programme, this medicine has both the potential to extend life, and to improve a patient’s quality of life. My unit will now be seeking to use this medicine for appropriate patients as soon as possible.”
Specifically, Zytiga is indicated for use alongside with prednisone or prednisolone in adult men whose disease has progressed after a docetaxel-based chemotherapy regimen. It was approved on Phase III data showing patients who received a combination of abiraterone plus prednisolone had a four month improvement in overall survival compared to those in the placebo arm.
Earlier this month after a preliminary review, NICE announced the drug - developed by Cancer Research UK and others – would not be routinely offered on the NHS. The Institute also said the drug did not meet the end of life criteria, which would have meant less stringent rules over cost applied. The AWMSG were able to approve abiraterone after assessing it as an end of life drug, meaning it will now be available on the NHS in Wales until NICE release their final guidance, which will override the AWMSG decision if abiraterone is rejected.
Professor Peter Johnson, Cancer Research UK’s chief clinician, said: “We’re pleased that the AWMSG and the drug’s manufacturer, Janssen, have agreed a price that makes abiraterone available for men in Wales who need it. But this is only guaranteed to happen for a few months until NICE release their final guidance.”
“We want Janssen to lower the price of abiraterone and NICE to take another look at the way they assessed its cost effectiveness. The AWMSG were able to approve the drug because they used the End of Life criteria. This shows that if NICE use these criteria, they could negotiate a price that makes abiraterone cost effective for the NHS.”