The National Institute for Health and Clinical Excellence (NICE) has issued new draft guidance recommending the use of Janssen's Zytiga (abiraterone) in men with castration-resistant metastatic prostate cancer.

The new draft recommendation - which recommends the drug's use in combination with prednisone or prednisolone where the disease has progressed after one docetaxel-containing therapy - reverses an earlier decision and results from Janssen submitting further information during the consultation on this previous draft.

This information included a revised patient access scheme (PAS) which involves providing the drug to the NHS at a discounted price, further information on which patients would benefit most and clarification on how many patients could receive the drug. 

These factors enabled the independent committee at NICE which appraised the drug to revise its preliminary decision and now recommend the drug for use on the NHS, said NICE's chief executive, Sir Andrew Dillon.

"We are very pleased that Janssen's submission to our consultation means that we are able to produce draft guidance recommending abiraterone - it is an effective treatment, potentially extending life by more than three months, and it also allows patients to be treated at home as it can be taken orally," said Sir Andrew.

The new draft guidance, which is now with consultees, was welcomed by the Institute of Cancer Research (ICR), where abiraterone was discovered.

"We are very pleased and proud that a drug we discovered will now be available to help many more men than before. This success highlights the important role that not-for-profit organisations can make in drug discovery and development," said the ICR's chief executive, Professor Alan Ashworth.

Patient advocates also applauded the news, with Owen Sharp, chief executive of The Prostate Cancer Charity, describing it as "a resounding triumph," and adding: "we are also pleased that the manufacturer responded to our call to deliver a further reduction in price."

"This laudable decision shows what can be achieved for patients when drug companies work collaboratively with NICE in a spirit of cooperation and compromise," added Emma Malcolm, chief executive of Prostate Action, which part-funded research and patient trials on the drug following its discovery at the ICR.

However, the charities note that while Zytiga is now available to suitable NHS patients in England, Wales and Northern Ireland, it remains out of reach to those in Scotland, and Mr Sharp pledged that The Prostate Cancer Charity will continue to appeal to ensure NICE's decision is mirrored in Scotland.

A final decision on Zytiga from the Scottish Medicines Consortium (SMC) is expected in September.