The National Institute for Health and Care Excellence (NICE) has issued draft guidance recommending Astellas Pharma’s Xtandi (enzalutamide) for treating hormone relapsed metastatic prostate cancer.
Xtandi is an effective treatment and, as it can be taken orally, it allows patients to be treated at home, said Professor Carole Longson, director of NICE’s Centre for Health Technology Evaluation.
Xtandi works in a different way to other drugs currently available for prostate cancer treatment. NICE’s draft guidance recommends it as an option for treating hormone relapsed prostate cancer in adults, only if their disease has progressed during or after one docetaxel-containing chemotherapy regimen and if the manufacturer provides it with the discount agreed in the patient access scheme (PAS).
The PAS provides a simple discount to Xtandi’s price of £2,734.67 for one pack of 112 40mg capsules, with the discount applied at the point of purchase or invoice. The manufacturer has estimated that the average cost of treatment with Xtandi is £25,269, based on the list price.
NICE says that its independent appraisal committee had heard that, although both Xtandi and Johnson & Johnson’s prostate cancer drug Zytiga (abiraterone) are oral treatments, only Xtandi can be taken on a full stomach, making it more convenient to take. The panel was also told that Xtandi can help control the cancer longer because there is no need to reduce the dose to prevent liver toxicity, as with Zytiga.
The draft guidance has been welcomed by Prostate Cancer UK, which points out that Xtandi is one of the few treatments shown to extend the lives of men with advanced prostate cancer.
The charity had “fought long and hard” to have Zytiga, which works in a similar way, available on the NHS, but Zytiga is not successful for every man, said the group’s chief executive, Owen Sharp.
“We need clinicians to have options at their disposal to do what counts – extend the lives of men with this disease when other options have run out. We need to see NICE confirm this decision as soon as possible,” Mr Sharp urged.
Dr Alan McDougall, medical and regulatory director at Astellas Pharma, described the draft guidance as “extremely positive.”
“Astellas strongly welcomes this news and we hope that this will enable eligible patients in England, Wales and Northern Ireland to access enzalutamide on the NHS in the near future,” he said.
