Prostate cancer is now the most commonly diagnosed cancer in England. Thanks to advances in research and treatment, survival rates have improved significantly – but only when patients are able to access the right treatment at the right time. That is why it is deeply concerning that a proven and cost-effective medicine is still not being funded for use in England, despite its availability elsewhere in the UK.
Each year, around 8,400 men in England are diagnosed with high-risk non-metastatic or locally advanced prostate cancer. A two-year course of the cheap generic drug abiraterone, taken alongside standard hormone therapy, has been shown to halve the risk of cancer progression and significantly improve survival. This is grounded in robust clinical evidence, most notably from the STAMPEDE trial.
In 2022, the drug’s patent expired, and the price of abiraterone dropped from several thousand pounds to just £77 per pack. That change made the treatment highly cost-effective. Indeed, an NHS England advisory body, the Clinical Priorities Advisory Group (CPAG), recommended abiraterone as a top priority for approval, noting that it had the highest relative benefit and lowest relative net cost per patient of the drugs it evaluated.
Wales and Scotland acted swiftly to make the treatment available. Yet in England abiraterone is only available and licensed for metastatic cases. The funding decision for expanded use in high-risk non-metastatic or locally advanced prostate cancer has been delayed by bureaucratic processes and budgetary concerns. During this time, it is estimated that more than 1,300 men in England have died from a cancer that, with timely access to this treatment, might have been cured.
We must not allow process to triumph over people. Each week that passes without action, a further 13 men are added to that number. This is not simply a matter of policy, it is a matter of urgency, of equity, and of doing the right thing.
Understandably, many men and their families are left feeling helpless. Some are spending their life savings to access abiraterone privately. Others simply cannot afford to – forced to accept poorer outcomes despite knowing a proven alternative exists. That is not the NHS at its best.
Prostate Cancer UK has been clear: this treatment will save lives and save money for the NHS. The charity is calling on the Government to urgently remove the bureaucratic barriers preventing men in England from accessing abiraterone, and to fund it without further delay.
The clinical case is compelling. The economic case is clear. If the evidence continues to be ignored, the question is not whether a decision will come – but how many more lives will be lost before it does.
We cannot afford to let this become a situation where action is taken only after mounting public pressure. This is an opportunity to get ahead of the curve and to demonstrate that our healthcare system can respond when the evidence demands it.
This is a reminder of the importance of consistency across the UK. When patients in one part of the country receive a standard of care that others do not, despite identical clinical needs, it undermines public confidence in the system as a whole.
As we work to modernise and improve the NHS, we must ensure that cost-effective innovation is not hampered by administrative delay. The systems we rely on must be rigorous, yes – but also responsive. When a treatment can extend lives, ease suffering, and reduce the long-term burden on services, it should not remain in limbo.
This is especially true now, as the Government sets out plans to abolish NHS England. While the long-term aim may be greater efficiency, the short-term effect is uncertainty – and there is a real risk that decisions of this kind will be pushed into the long grass. But with that reform also comes greater ministerial oversight. The Government now has both the opportunity and responsibility to intervene. It must seize it.
We owe it to the men and their families who are currently caught in this avoidable gap between evidence and access. Let us not look back in another year’s time and wonder why we failed to act when the path was so clear.
Let us do the right thing now.
A Two-Year Delay That Has Cost 1,300 Lives — It’s Time to Fund Abiraterone
