Prices of androgen deprivation HT drugs?

Bicalutimide costs peanuts - its patent has expired and it's available as a generic medicine.

Abiraterone costs about £24 per day (source: NICE)

Enzalutamide costs £98 per day (source: NICE)

Cheers,

Chris

EDIT: The price given above for Abiraterone is per tablet, but the NICE website doesn’t say what dosage tablet! I see that normal dosage is either 2x500mg or 4x250mg tablets a day, so that makes the cost either £48 or £96 a day.

Edited by member 09 Jan 2019 at 17:21  | Reason: Not specified

Just asking, as I am taking a friend in his late eighties whose course of Bicalutamide has failed after two years, to see a uro-oncologist on Friday, and I hope that any alternative prescription will be patient-based, rather than cost-based.

Cheers, John.

My old mate (who is still all there) has been very supine about his cancer, with a ‘doctor knows best’ attitude, so common amongst people of his generation. He’s not really sure if he’s ever had an MRI scan, doesn’t know which HT implants he has every three months, etc., etc.

So we will find out what’s what on Friday. He is very lucky anyway as he has got no symptoms of his PCa, nor any side-effects from his hormone therapy over the last four years since his diagnosis.

It must be very difficult for oncologists to decide treatment plans for geriatrics, as my pal wouldn’t want any invasive treatment or biopsies, but he is well apart from inevitable arthritis, and I wouldn’t be surprised to see him live to a hundred. That’s if I’m still around😉.

Cheers, John.

Edited by member 09 Jan 2019 at 19:27  | Reason: Not specified

Ah, sorry - ignore the last bit of my previous post. I assumed from your previous comment that he had only had bicalutimide for the last two years. Useful info on Friday then will be to find out when they added the bical - the obvious next step is to stop the bical and hope for the withdrawal response. 

You could ask whether his testosterone is being measured and if so, what his current level is. 

Bicalutimide and Enza don’t lead to chemical castration. 

‘When will these GPs get their act together?’ he muttered, whilst glaring at his computer screen. (I could have told him a few things about GPs, but decided not to on this occasion).

‘How would I know, he’s not even my patient!’ When I asked if Chris had ever had an MRI scan. Not the best ‘bedside manner’.

When he calmed down, he arranged an ‘urgent’ CT scan, which radiology tell me takes up to four weeks. He said a CT is better than mpMRI for potential lymph node metastases. He discussed the possibility of Abiraterone and Docetaxel in the future, and in the meantime prescribed 1mg of Diethylstilbestrol, which Dr Wikipedia tells me harks from 1938 and is rarely prescribed nowadays due to to its hideous side effects including ‘cardiovascular morbidity’ = death?

I have told Chris to stop taking them if he has any hint of side effects at all. In fact he’s been very lucky as he’s been on Zoladex for over four years, and Bicalutamide for two, and his only side effect has been the reduction in his PSA from over 300 to under 10.

In fact the urologist said Casodex usually only works for an average of twelve months, before the cancer becomes resistant, so Chris was lucky again.

Chris is a sprightly 87 year old, with a bit of hip trouble and backache, but otherwise a walking miracle.

Cheers, John.