Prostate Cancer Treatment

Danny Beales Excerpts

Tuesday 17th June 2025 Commons Chamber

[Dr Huq]

I completely agree with the hon. Gentleman that access should be based not on how deep somebody’s pockets are, but on need.

Abiraterone halves the risk of relapse. Each relapse literally costs the NHS millions—the definition of lose-lose. As many Members have pointed out, it is already successfully available on the NHS and routinely funded for use in metastatic cases in England, but sadly there is a catch: abiraterone is not available on the NHS for men with non-metastatic prostate cancer living in England.

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

I thank my hon. Friend for bringing forward this very important debate for her constituents, my constituents and people in the UK. Does she agree that since this issue was last assessed by the National Institute for Health and Care Excellence, there have been significant developments, as has been mentioned by other colleagues, both in the provision of the drug in other nations and the fact that it is now available off-patent, so it is much cheaper to access? That will fundamentally change the cost-benefit analysis that NICE did previously. Does she agree that her constituents and my constituents need this drug just as much as patients in Scotland and Wales who are benefiting from it?

[Dr Huq]

I totally agree. West London needs the same as the west of Scotland, the west of Wales, and all the other bits of those other nations. Men can access abiraterone on the NHS in Scotland and Wales, but not in England, even with an identical diagnosis. It seems at best anomalous that their postcode, not their prognosis, is determining their treatment, and we all know that the NHS is meant to be free at the point of need.

I would give anything to have had longer with my dad. I was reminded of him when, like the hon. Member for Harrogate and Knaresborough (Tom Gordon), I had someone come to see me: Peter Treadgold, who came to my advice surgery and pointed out that he is falling between the cracks. He had a long-standing diagnosis, with remission, and he diligently followed all the advice. He was under NHS monitoring for 20 years because he had heightened prostate-specific antigen levels, although he was never actually offered an MRI or ultrasound scan. Last year, his cancer came back, and he was told that he would need hormone and radiation therapy; abiraterone was not offered. Peter is one of the one in three people who get the devastating news that their cancer has come back, and has been denied access to a treatment that could save or extend his life.

The first time I heard of abiraterone was when I met Peter, because as my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) said, in my dad’s day, it would not have been cost-efficient. However, it is now a generic drug—it has gone off patent—but it is licensed only for metastatic cases. As my hon. Friend the Minister knows well, there is a complicated, convoluted process involved in getting it approved for non-metastatic cases. There is no question about the effectiveness of abiraterone. It has had one of the biggest trials known to mankind, a genuinely world-beating trial. When NHS England’s own clinical priorities advisory group plotted the clinical benefit against the net cost, abiraterone scored highest in that tabulation. It is calculated that two years of abiraterone treatment would halve the death rate for men with locally advanced prostate cancer, but we hear about budgetary challenges. I have written to the Minister and tabled questions, and have been told that NHS England has not identified the recurrent budget to support provision of the drug.

We should look long-term, at the remissions, and at the cost of chemotherapy, hospital appointments and other associated things. Those costs add up. University College London found that abiraterone would pay for itself if it were £11 a day. Do Members know what the NHS is actually paying? Does anyone want to hazard a guess? Oh, we are not doing call and response. Abiraterone costs £2.75 a day, now that it is off patent and has come down in price. That is less than three measly quid to avoid costly relapses, scans, chemo, hospital appointments and everything else—less than three little round ones to improve lives and reduce deaths. As we have heard, only people who can fork out up front for private treatment or private medical insurance currently have that option, and again, our NHS was not meant to be for private profiteering or big pharma drug pushers. People are seeing their pensions and life savings evaporate, and we are in a cost of living crisis. This drug should be universally available.

It took less than one year for abiraterone to be approved for men with non-metastatic prostate cancer in Scotland and Wales. In England, it is now three years and counting, and we still have not had a concrete resolution. Right now, abiraterone is the cheapest and most cost-effective it has ever been, and as the excellent Prostate Cancer UK put it, the postcode lottery must end. Lord Darzi’s independent investigations into the NHS found that the UK had higher cancer mortality rates than other comparable countries, and sadly, progress in diagnosing cancer at stages 1 and 2 is flatlining. Just over half of prostate cancers are caught at an early stage. That falls well short of the NHS target of 75%. I appreciate that Labour has just come into power after 14 years of the Conservative party, so it will take time to fix our health system, but we need it to be more responsive—to act early and rapidly, to use all the tools it can, and to offer preventive rather than after-the-fact care in every case. Abiraterone exemplifies all those things.

I welcome the Chancellor’s 3% real-terms increase in NHS spending to deliver the exciting plan to build an NHS fit for the future. With the 10-year plan coming soon and the national cancer strategy due this autumn, we have a real chance to deliver significant improvements for people living with cancer, so as is customary, I have a list of questions for the Minister. I will incorporate those of my hon. Friends—I think we are all friends here, even if we sit on opposite sides of the Chamber.

First, will the Minister commit to exploring ways of ensuring that additional NHS funding is used to make abiraterone available to all men who need it in England—and in Northern Ireland, as the hon. Member for Strangford (Jim Shannon) has pointed out? Secondly, will the Minister support the introduction of a national programme of screening for prostate cancer, like those that we have for comparable cancers in the United Kingdom? Thirdly, given the complexity of NHS England’s decision-making processes in relation to the availability of abiraterone—which sound like a right old bureaucratic nightmare—as the functions of NHS England are transferred back to the Department of Health and Social Care, will the Minister take steps to ensure that all decisions about access to medicine, including abiraterone, are timely and transparent? I know that she has had a long career in the NHS, and as I have said, she is on the side of the angels.

Fourthly, will the Minister commit to publishing an equality impact assessment, given the disturbingly disproportionate effect that prostate cancer is having on black men, who are more likely to develop it and to receive a late diagnosis, and less likely to receive the right treatment? I am doing this partly for Dad, who is watching from somewhere up above, but also for the black and minority ethnic men who are implicated here and now. This is the second time that you have been in the Chair, Madam Deputy Speaker, when I have been talking about health inequalities since Friday, when we discussed assisted dying. You have chaired both debates excellently.

Fifthly, in the light of the lengthy approval process, will the Minister assess the adequacy of the funding formula model—we have NICE and we have the Medicines and Healthcare products Regulatory Agency, and it all seems a bit knotty—and consider whether novel pharmaceutical treatments could be produced cost-effectively, especially, as my hon. Friend the Member for Uxbridge and South Ruislip said, when they come off-patent. I am arguing for simplification in cases in which drugs are already prescribed for limited use and there is a credible case for expanding their application to a generic treatment. We are halfway there; we just need to go that little bit further.

Prostate Cancer UK estimates that 672 men die prematurely each year because we have no access to abiraterone. Each week that this continues, 13 men in England will die from a cancer that could have been treated cheaply had they lived in Scotland or Wales. Labour is the party of the NHS, and a Labour Government introduced the UK’s first dedicated cancer strategy; so let us go for this win-win for all, end the iniquitous, unjust postcode lottery, celebrate the best of British science, and widen access to abiraterone for all those who need it, not just those who can afford it.