The Scottish Medicines Consortium has ruled that Sanofi-Aventis’ Taxotere (docetaxel) should not be prescribed for men with metastatic hormone-refractory prostate cancer because it is too expensive.

The SMC – Scotland’s equivalent to the National Institute for Health and Clinical Excellence in England and Wales – said in a statement that docetaxel in combination with prednisolone had been shown to extend survival in prostate cancer patients who no longer respond to hormone treatment, and also relieved pain and improved their quality of life. But it went on to say that ‘the cost-effectiveness of docetaxel for MHRPC has not been demonstrated’, so it should not be prescribed on the National Health Service.

The Prostate Cancer Charity reacted with dismay at the ruling, saying: “this decision is very bad news for men in Scotland and it does not bode well for the NICE consultation on the same drug next year for men in England and Wales.”

“Whilst cost must clearly be taken into account by the NHS in reaching decisions about drug funding, it is essential to recognise that Taxotere is, as yet, the only drug proven through rigorous trials to offer improved survival and quality of life to men with prostate cancer at this stage of their illness,” said John Neate, the charity’s chief executive. Taxotere was approved for this indication across the European Union last year [[04/11/04d]].

He suggested the decision may invite legal challenges to NHS decisions on drugs if patients feel that drugs they need and have been clinically recommended are refused by their Primary Care Trust.

The SMC suggested that it would revisit the issue if it received additional data from the manufacturer supporting Taxotere’s use in this patient population. Last month, the agency backed the use of Taxotere in early-stage breast cancer [[11/10/05e]].

Prostate cancer is the most common for of cancer affecting men, and kills around 10,000 people each year in the UK.