UK - Abiraterone too expensive for no... - Advanced Prostate...

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UK - Abiraterone too expensive for non-CRPC mPCa?

pjoshea13 profile image
16 Replies

"The United Kingdom’s National Institute for Health and Care Excellence (NICE) has chosen not to recommend abiraterone acetate (Zytiga) with prednisone/prednisolone plus androgen deprivation therapy (ADT) as a treatment for patients with newly diagnosed, high-risk hormone-sensitive metastatic prostate cancer."

'“There are concerns that the trials may overestimate the effectiveness of abiraterone,” the agency wrote in the final appraisal document.'

onclive.com/view/nice-passe...

-Patrick

16 Replies
pjoshea13 profile image
pjoshea13

Janssen response:

firstwordpharma.com/node/17...

cesces profile image
cesces

Patrick

If I read this correctly, their objection is totally about cost. They seem to dance around it, but that's it. Docetaxel is cheaper, so they are going to deny all patients abiraterone acetate (Zytiga) .

Do I get that right?

I'm not certain who to be more pissed at Jantzen for it pricing or the health system. Shame on them both.

pjoshea13 profile image
pjoshea13 in reply to cesces

Janssen & NICE are old hands at this.

Four years ago NICE agreed to pay for Abi in CRPC cases that had not received chemo. Abi had been approved 18 months earlier for post-chemo CRPC. The drug cost £3,000 a month at that point. Janssen sharpened its pencils & ultimately came back with a price of £2,300 - with a rebate for treatments beyond 10 months.

NICE meanwhile decided that new evidence showed that there was indeed benefit for the ~5,900 men who would become eligible.

It's a game. But NICE has i tight budget.

I wonder how Janssen came up with that 10 months?

-Patrick

Hirsch profile image
Hirsch in reply to cesces

How about a generic version?

cesces profile image
cesces in reply to Hirsch

Good question, though generic classification is a country specific determination.

ritchiek profile image
ritchiek

Patrick , the availability of Abiraterone for mHSPC in the UK during the COVID crisis is more complicated than you suggest.

I believe that Abiraterone was available in Scotland & Wales but not England pre-COVID.

In England only chemotherapy was available. Now however Enzalutamide has been given temporary approval, & Abiraterone is available to those who are intolerant of Enzalutamide.

DarkEnergy profile image
DarkEnergy in reply to ritchiek

So, what's the point of having an Oncologist in England, once diagnosed with PCa, just hand out very NICE pamphlets...

From what I've read, there are other nationalised healthcare systems that require chemotherapy before either Xtandi or Zytiga. They look at at the outcomes vs. cost. I do blame Big Pharma greed for this. The price of Zytiga is ridiculous.

GreenStreet profile image
GreenStreet

Not very Nice! Seems to be purely budget driven. Not surprised but disappointed hopefully it will be appealed.

Grumpyswife profile image
Grumpyswife

I forget the answer to this because my husband is metastatic hormone resistant. But aren’t there alternative meds approved in the UK for use only in metastatic hormone sensitive pCa?

And, it certainly hasn’t helped the cost having abiraterone go generic in our personal experience. We had much better coverage for Xtandi costs through their assistance program.

I've been using their assistance program for over a year. So I pay $10 a month for the drug. I doubt that this even covers the pharmacy shipping and the overhead. So, drugs for free? Never been a hitch and resets each year w/automatic courtesy call from Janssen.

How does the rebate work? I know how it works for the patients but how does it work financially for Janssen? Are they relying on my becoming psychologically and therapeutically dependent on the drug and then stopping the copays at some time? Or is it good PR for other products?

Just thought of another angle. I take the drug. I pay pretty much nothing and there is no profit or even a small loss for Janssen. But they get my insurance co-pays (I think these are about 2k or maybe more per month). So they make 2k+ a month on the drug. (And part of the copay assistance requirements are that you need to be covered by insurance and be a citizen.)

But I'm ok with that. End result for me is that I can use a clinically beneficial drug w/ a cost that makes it less expensive than a month's worth of green tea.

Grumpyswife profile image
Grumpyswife in reply to

That's how it was last year for us on BCBS Anthem. Now Our current insurance Aetna charges me for the copay anyway. This year with our crappy Aetna insurance we used up our Zytiga Janssen assistance after one month (January). The next month's bill for the 30 days of Zytiga was $1700 which I didn't refill.

And regarding Leo's comment below he is lucky to have a doctor's office to help. The one we are deal with now could care less and just doesn't understand the current issue.

Everyone assumes you always save with generics but in our case with abiraterone there was no generic used by crappy Aetna insurance that allowed the copay assistance. They used a generic manufacturer that didn't allow the copay assistance for our retiree insurance. It's difficult to know this until you experience it yourself.

depotdoug profile image
depotdoug

Or sooner than 01/01/2021.

The way they’re gouging $’s and £’s JANSSEN that is. My XARELTO 20mg daily is $597.00 retail per month, thank goodness my insurance pays $474. I’m on that for life it looks like.

leo2634 profile image
leo2634

I don't know your options in the UK but here in the US we have a network of grants and help to pay for Zytiga. When I was prescribed it almost three years ago I had a copay of around $1,800.00 a month then when the generics came along it went down to around $400.00 a month. I am fortunate enough to have a Doctor and his staff that did all the leg work for me in securing the grants. I haven't paid for any prescription so far. Leo

in reply to leo2634

I have cigna and am non-crpc. I pay $10 a month after insurance and Janssen assistance. Been on it over a year.

Flash64 profile image
Flash64

It's the same here in New Zealand. I have to pay out of pocket fro mine since I'm non-CRPC mPCa

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