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Do you need to move to Scotland to get access to Abiraterone in mHSPC

User
Posted 14 Jan 2020 at 04:05

Hello. I see Abiraterone was approved today by the SMC in Scotland for high risk patients with metastatic hormone sensitive prostate cancer.  The first drug to be approved in this indication of high unmet need.  My English based Father (but with family roots in Scotland) has high risk mHSPC, so my question is...does he need to move to Scotland to get access to it?  Would he have to buy or even rent? Give up his house in England?

The only alternatives I see to this (bar staying on ADT alone until becomes Castration resistant) would be to:

- Pay privately.  Would be around £36k a year.  Anyone paying privately for Abi? Or paying until it is hopefully then funded?

- Else wait and hope it is NICE approved soon for rx'ing in NHS England - but could ge a long wait!

- Wait and hope that Enzalutamide or Apalutamide get their mHSPC licenses soon for mHSPC, and also rx'd in NHS England

- Any other alternatives?

Thanks for thoughts, as really want best possible outcomes for my Father, who is also a carer himself, but would rather not use up all life savings, which I would happily do to help him live longer

User
Posted 14 Jan 2020 at 09:41
I read on another site that NICE are making a decision tomorrow about whether Abiraterone can be prescribed as front line treatment alongside HT for men dx with stage 4 PCa rather than having chemo. This is following positive results from the Stampede trial

On the same forum it stated the patent is due to run out which means generic costs will drop

Bri

User
Posted 14 Jan 2020 at 23:15

The link below is a recent study on up front Docetaxel, the same site also has the papers reffered  to regarding ABI and Enzo

Take a look at this content on PracticeUpdate: http://prac.co/l/rqmrjba

 

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User
Posted 14 Jan 2020 at 08:47
Not sure what the problem is with staying on routine HT until he becomes hormone independent and then adding enzo or abi (depending on which the onco thinks will suit him better)? Moving house causes great stress and upheaval and I am pretty sure the health services will be picking up on any suggestion of health tourism. Plus the earlier you start these drugs the earlier they might fail.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 14 Jan 2020 at 09:41
I read on another site that NICE are making a decision tomorrow about whether Abiraterone can be prescribed as front line treatment alongside HT for men dx with stage 4 PCa rather than having chemo. This is following positive results from the Stampede trial

On the same forum it stated the patent is due to run out which means generic costs will drop

Bri

User
Posted 14 Jan 2020 at 13:15

Can anyone tell me if HT plus Abi been shown to have a better outcome in men diagnosed with advanced PCa than HT plus docetaxel, please? 
Thank you

 

 

User
Posted 14 Jan 2020 at 23:15

The link below is a recent study on up front Docetaxel, the same site also has the papers reffered  to regarding ABI and Enzo

Take a look at this content on PracticeUpdate: http://prac.co/l/rqmrjba

 

User
Posted 15 Jan 2020 at 09:28

Many thanks francij1 I will try to get my head around it.

User
Posted 16 Aug 2020 at 10:45

I’m a bit late to this I know, and things may well have moved on since the original post. I just wanted to add though that I was initially prescribed Apalutamide by NHS Wales (even though I actually live just over the border in England, my GP is in Wales). I was on it for a couple of months before the medics decided I was experiencing “unacceptable toxicity“ due to incredible fatigue which left me feeling like a zombie, and changed me to Abiraterone. I still get some fatigue but I can live with it now. I understand that Prostate Cancer Uk are campaigning through NICE to make Apalutamide available on NHS England.

 
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