In a sudden reversal of its prior opinion the UK’s National Institute for Health and Care Excellence (NICE) has issued final guidance recommending Janssen’s Zytiga (abiraterone) to treat advanced prostate cancer before chemotherapy. Its prior recommendation was not to approve Zytiga.

TAccording to NICE their decision to change their December 2015 recommendation follows the submission of new evidence on the drug’s benefits. At that time NICE indicated that the initial data submitted by Janssen failed to demonstrate quality of life and long-term survival.

Since the denial Janssen has submitted extra data from a large group of men treated with Zytiga in the US, which demonstrated that 14% were still taking the drug after 4.4 years.

The unpolished part of the story is that Janssen has also decided to provide economic discounts for the drug. In the UK the current list price of Zytiga is £2,930 for 120 tablets and NICE said the price was expected to fall to £2,300 by the time its final guidance is published.  The question remaining is what actually motivated NICE’s decision, money or men’s well being?

Additionally, s a further economic incentive Janssen has also agreed to rebate the cost of any tablets required beyond 10 months of treatment.

Totally ignoring the value of the economic concessions the NICE Director of the Centre for Health Technology Evaluation Carole Longson said: “I am very pleased that the new evidence submitted has meant we are able to recommend abiraterone.

“There are few treatments available for patients at this stage of prostate cancer so this is very good news.”

To set things straight it was the Institute of Cancer Research (ICR) in London, which discovered the drug. The ICR chief executive Paul Workman said: “This is a big victory for men in England with prostate cancer, and means they will finally catch up with the US, Europe and indeed Scotland in being able to access abiraterone (Zytiga) earlier in the course of treatment.”

For this particular drug it doesn’t matter why NICE has finally come round, what counts is that it has finally provided the guidance that men in the UK so deserve. However, men in the UK still can be denied needed other treatments if the economics continue to make a larger part of their future decisions.