4 minutes Morag Idan

Prostate Scotland statement on SMC decision on enzalutamide for high-risk non metastatic castration resistant prostate cancer

“We are disappointed that it has been decided not to make enzalutamide available as an option for the treatment of high risk non-metastatic hormone resistant prostate cancer in Scotland. However, we understand the rationale behind the SMC’s (Scottish Medicines Consortium) decision. We call on the manufacturers of enzalutamide to undertake further research into and provide further information about the overall survival impact, the role in the treatment pathway and cost effectiveness of enzalutamide, so that potentially in future men with high risk non-metastatic castration resistant prostate cancer in Scotland could have access to it as a treatment option.”

“Whilst the number of men likely to benefit from such a medicine is small, the information to date suggests that enzalutamide can lead to longer periods of metastasis/progression free survival, compared to men receiving androgen deprivation therapy alone (the standard therapy). Men with prostate cancer we consulted felt that it could be helpful if it could be made available as a treatment option for men whose cancer has not yet spread, but where hormone therapy is no longer working. We hope the manufacturers can work with the SMC in the future to help enable the cost of making this medicine available to men with prostate cancer to be cost effective as a treatment option for non-metastatic high risk castrate resistant prostate cancer.”


1. Prostate cancer is the most common cancer amongst men in Scotland, with a lifetime chance of one in ten men developing it. There were over 33,258 new registrations of men with prostate cancer between 2005 and 2015 and 9,316 deaths of men in Scotland from prostate cancer during that period.[i]. Encouragingly survival rates amongst men with prostate cancer have doubled over the past two decades with 80% of men with prostate cancer now surviving it[ii]. [iii]. Over the past 20 years the number of men surviving prostate cancer has doubled and survival rates are now 80%. Projections by the NHS show that the diagnosis of men with prostate cancer is likely to rise by up to 35% between now and 2027. High risk non-metastatic castration resistant prostate cancer is prostate cancer which has not spread, but is at high risk of doing so and is resistant to hormone treatments.

2. Prostate Scotland is a registered Scottish charity no SC037494. It was set up in 2006 as a Scottish charity to develop awareness of prostate disease, to support men and their families/ partners with the disease through providing advice and information and to advance treatment and research into prostate disease. Its aim is to reach out across Scotland to create greater awareness amongst men and their families/partners about prostate disease and to advance treatment. It has established an award winning website www.prostatescotland.org.uk providing a wide range of information about prostate disease and treatments, as well as providing information and advice about prostate disease to men and their families across Scotland. In 2010 the charity won a national award for its impact on community health and in 2013 and 2015 was commended in the British Medical Association Patient information Awards, and in 2017 was awarded Scottish health charity of the year. Prostate Scotland is a registered Scottish charity No.SC037494

[i] See Scottish Cancer Registry May 2017 and Cancer in Scotland, Information Services Division NHS National Services Scotland April 2017

[ii] Cancer in Scotland: ISD, NHS National Services Scotland, September 2011

[iii] See Scottish Cancer Registry May 2016 and Cancer Incidence in in Scotland (2014), and Information Services Division NHS National Services Scotland  November 2015