Deadly waiting game for prostate cancer drugs

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Prostate cancer patients have to wait many years to get access to new cancer medicines compared to other countries such as the US. This is resulting in poorer quality of life and death for Australians, according to Australian Advanced Prostate Cancer Support Group committee member Paul Hobson.

Hobson cites the example of two new anti-androgen drugs for prostate cancer (Zytiga and Xtandi). He says many patients have had to wait several years for them, despite their being available overseas.

“Current best practice in the US is to use one or other of these drugs once a patient with prostate cancer becomes castration-resistant, and prior to chemotherapy.  If one of these drugs is not, or ceases to be effective than the other drug will be used,” says Hobson.

He added that both drugs were being evaluated in clinical trials as the primary hormonal therapeutic approach for patients before the cancer becomes castrate-resistant because they may delay the need for chemotherapy. Also, they also have the advantage of being able to be administered at home, therefore, reducing the need for hospital-based care.

Hobson outlined details of how access to these drugs differs between Australia and the US.

In April 2011 the US Food and Drug Administration (FDA) approved Zytiga, in combination with prednisone, to treat patients with late-stage (metastatic) castration-resistant prostate cancer, who had received prior docetaxel (chemotherapy). A year later it was also approved for use prior to chemotherapy in the US.

But it took until 2014 for the drug to be approved here on the PBS for patients with late-stage, castration-resistant prostate cancer, and only for patients who had received docetaxel prior. And it is not available on the PBS for pre-chemotherapy patients.

In the case of Xtandi (enzalutamide), that got the FDA tick of approval in August 2013 for patients with metastatic castration-resistant prostate cancer, and who had undergone chemotherapy. It was then approved for pre-chemotherapy in 2014.

But in Australia it only became available on the PBS in December 2014, and only for patients who had received docetaxel prior. And like Zytiga, the drug is still not available on the PBS for patients who have not undergone chemotherapy, said Hobson.

More information on accessibility of cancer drugs can be found in reports such as: the Deloitte Access Economics Access to Cancer Medicines in Australia Report July 2013 ;the Reimbursement success rates and timelines for new medicines for cancer; an international comparison (2014) prepared for the Medicines Australia Oncology Industry Task Force and the International Comparison of Medicines Usage: Quantitative Analysis prepared by the UK Office of Health Economics (2014).

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