Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will make an estimate of the potential impact of prescribing abiraterone in England using the eligibility criteria used in (a) Scotland and (b) Wales on the number of premature deaths from high-risk, non-metastatic prostate cancer.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England estimates that the number of eligible patients in England is between 7,500 and 9,500 per year. This is based on the same eligibility criteria as are used in Scotland and Wales.

NHS England has not completed any specific work to estimate the potential impact of prescribing abiraterone in England using the eligibility criteria used in Scotland and Wales on the number of premature deaths from high-risk, non-metastatic prostate cancer. However, the policy was ranked as the top priority for routine commissioning at the Clinical Priorities Advisory Group Prioritisation Meeting in 2024/25, based upon the clinical benefit, which included evidence that demonstrated statistically significantly fewer deaths with abiraterone and androgen deprivation therapy versus androgen deprivation therapy alone.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential merits of minimally invasive therapies for the less survivable cancers.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

Ongoing research is exploring the potential of minimally invasive cancer therapies for less survivable cancers. This includes non-invasive liver cancer treatments that use ultrasound technology to destroy tumours without surgery, scalpels, or radiation, with minimal damage to surrounding organs.

The adoption of new treatments, including minimally invasive cancer treatments for less survivable cancers, into the National Health Service in England is generally the result of National Institution of Clinical Excellence (NICE) guidance and/or commissioner decisions.

The NHS has launched a new £2 million programme which is funding 300 general practices to identify pancreatic cancer early by screening high-risk patients over 60 years old with new diabetes diagnoses and unexplained weight loss for urgent testing.

Both NHS England and the integrated care boards are required to put in place access for any treatment that carries a positive recommendation from the Technology Appraisal programme, operated by NICE. Agreements on timelines and funding for making therapies available on the NHS can vary, with implementation supported by the service readiness assessment and the development of additional capacity where necessary.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will make an estimate of the (a) cost per patient, (b) number of eligible patients, (c) net cost, (d) incremental quality-adjusted life years gained and (e) incremental cost-effectiveness ratio of extending abiraterone access to high-risk, non-metastatic prostate cancer patients in England.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England is unable to provide information related to the cost per patient as disclosure of this information could be used to identify the discounted price that we have agreed and would prejudice the commercial interests of both NHS England and the supplier.

The number of patients eligible for abiraterone for the treatment of high-risk, non-metastatic prostate cancer is between 7,500 and 9,500 per year.

The total net cost of the policy, including the drug cost, to NHS England is estimated to be approximately £49.36 million over five years.

NHS England has not calculated the incremental quality-adjusted life years gained or the incremental cost-effectiveness ratio because NHS England uses a relative prioritisation process for policy propositions that require funding in line with the published NHS England Specialised Commissioning Service Development Policy, which is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2017/09/B0026_NHS-England-Specialised-Commissioning-Service-Development-Policy.pdf

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what estimate his Department has made of the number of men in England with newly diagnosed high-risk, non-metastatic prostate cancer who would be eligible for abiraterone under the eligibility criteria used in (a) Scotland and (b) Wales.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England estimates that the number of eligible patients in England is between 7,500 and 9,500 per year. This is based on the same eligibility criteria as are used in Scotland and Wales.

NHS England has not completed any specific work to estimate the potential impact of prescribing abiraterone in England using the eligibility criteria used in Scotland and Wales on the number of premature deaths from high-risk, non-metastatic prostate cancer. However, the policy was ranked as the top priority for routine commissioning at the Clinical Priorities Advisory Group Prioritisation Meeting in 2024/25, based upon the clinical benefit, which included evidence that demonstrated statistically significantly fewer deaths with abiraterone and androgen deprivation therapy versus androgen deprivation therapy alone.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what information his Department holds on the estimate made by (a) NHS England, (b) NHS Wales and (c) NHS Scotland of the incremental cost-effectiveness ratio for abiraterone in high-risk, non-metastatic prostate cancer.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England has not calculated the incremental cost-effectiveness ratio for any policy proposition because NHS England uses a relative prioritisation process for policy propositions that require funding in line with the published NHS England Specialised Commissioning Service Development Policy, a copy of which is attached.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether NHS England has approved any drugs with a higher incremental cost-effectiveness ratio than abiraterone for high-risk, non-metastatic prostate cancer in the last five years.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

NHS England has not calculated the incremental cost-effectiveness ratio for any policy proposition because NHS England uses a relative prioritisation process for policy propositions that require funding in line with the published NHS England Specialised Commissioning Service Development Policy, a copy of which is attached.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, how the full roll-out of the non-specific symptom pathways is being measured; and how their development has included the less survivable cancers.

Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)

Since 2019, NHS England and cancer alliances have been developing non-specific symptom (NSS) pathways for patients who present with vague and non-site-specific symptoms which do not clearly align to a tumour type. Full roll out of NSS pathways has been achieved with 115 live NSS pathways across England. This is particularly relevant to less survivable cancers which are often diagnosed at a later stage due to their non-specific symptoms.

Trusts and providers are working to achieve the Faster Diagnosis Standard (FDS), which ensures patients are diagnosed or have cancer ruled out within 28 days of being urgently referred. NSS pathways should support patients until they are diagnosed and referred onward or their symptoms resolve, aligning with the FDS, and providers of NSS pathways should ensure patient administration systems can capture and report the NSS referral and any subsequent diagnosis.

Additionally, best practiced timed pathways to support the FDS are being developed for all suspected cancer pathways, including NSS pathways.

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether the NICE guidance on abiraterone produced in 2021 was based on abiraterone's cost in generic form.

Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)

The National Institute for Health and Care Excellence’s (NICE) published guidance on abiraterone for treating newly diagnosed high-risk hormone-sensitive metastatic prostate cancer, which has the reference code TA721, was developed before the patent for abiraterone expired and was therefore based on the cost of the branded medicine.

NICE is now re-evaluating abiraterone, both the originator and the generics, for the treatment of newly diagnosed high-risk hormone-sensitive metastatic prostate cancer and currently expects to publish the final guidance on 19 November 2025. The progress of this guidance can be followed at the following link:

https://www.nice.org.uk/guidance/indevelopment/gid-ta11730

Found: Danny Beales: Once.

Found: Q26 Danny Beales: I have two questions for Alice and Jayda.