Northern Ireland men denied life-saving prostate cancer drug available across UK

North Antrim MP Jim Allister and Health Minister Mike Nesbitt

Men in Northern Ireland with prostate cancer are being denied access to a life-extending drug already available to patients across the rest of the UK — prompting warnings of a “postcode lottery” that could cost lives.

The drug, abiraterone, is prescribed across the UK for men with advanced prostate cancer that has spread. But while patients in England, Scotland and Wales can now also receive it for certain high-risk cases where the cancer has not yet spread, men in Northern Ireland cannot.

Campaigners and politicians say the gap means patients here are missing out on a treatment proven to significantly improve survival.

Calls for urgent action

North Antrim MP Jim Allister has written to Health Minister Mike Nesbitt urging urgent action after being contacted by a constituent seeking access to the drug.

Mr Allister said the disparity between Northern Ireland and the rest of the UK was “shocking”.

“The shocking disparity is that while the drug has just been made available in England and has been available in Scotland and Wales since 2023, it is still not an option for sufferers in Northern Ireland,” he wrote.

“My constituent is only one of many men in this country who would benefit from abiraterone. It is utterly unfair that, due to their postcodes, they are facing an uncertain future because they are being denied free access to this drug which could greatly improve their prognoses.

“In the other nations of the UK, ministers and health authorities identified a means within existing frameworks to supply the drug. I urgently ask that the overwhelming evidence is acted upon and that men in Northern Ireland are given the same opportunities and, therefore, the same prospect of surviving this terrible disease.”

Evidence shows major survival benefits

Abiraterone works by starving prostate cancer cells of the hormones they need to grow.

Results from the major STAMPEDE clinical trial, published in 2022, showed the treatment can:

• improve survival chances

• halve the risk of prostate cancer returning

• reduce the risk of death by 40%

The charity Prostate Cancer UK, which has campaigned for wider access to the drug, says a two-year course alongside standard treatment could transform outcomes for men with high-risk disease.

Amy Rylance, Director of Health Services, Equity and Improvement at the charity, said:

“Research has proven that a two-year course of abiraterone alongside standard treatment can halve the number of men with high-risk, non-metastatic prostate cancer who go on to die from the disease.

“It is available cheaply, and we know that prescribing it to men would not only save HSCNI costs from treating recurrence but would also save hundreds of men’s lives over the next five years.

“Despite this, Northern Ireland is now the only part of the UK where this life-extending drug is not available to the men who need it most. This is deeply unfair.”

Why Northern Ireland patients cannot access it

In his response to Mr Allister, Health Minister Mike Nesbitt said the issue arises because Northern Ireland lacks a medicines approval body equivalent to those operating elsewhere in the UK.

While England can approve medicines through NHS England and Scotland and Wales have their own assessment bodies, Northern Ireland relies largely on decisions from the National Institute for Health and Care Excellence (NICE).

Mr Nesbitt explained that when NICE has not yet completed a full appraisal or recommendation, the Health and Social Care system in Northern Ireland does not routinely commission the treatment.

“In circumstances where NICE is yet to complete a full appraisal, or does not recommend a particular drug, the Department’s Strategic Planning and Performance Group (SPPG) does not routinely commission that therapy for use in Northern Ireland,” he said.

“Unlike other parts of the United Kingdom, Northern Ireland does not have its own health technology assessment body or equivalent to NICE, Scottish Medicines Consortium or All Wales Medicine Strategy Group, that could make a bespoke determination for Northern Ireland patients in the absence of NICE guidance.”

Review underway — but funding pressures remain

The Minister confirmed that a review of medicines access arrangements is now underway to improve how treatments are approved in Northern Ireland.

However, he warned that any changes — including new systems to approve drugs outside existing guidance — would need to be considered alongside the Department’s “challenging financial position and competing priorities”.

Campaigners say the review must move quickly.

Prostate Cancer UK is urging Stormont leaders to create a mechanism to approve the drug and end the disparity with the rest of the UK.

“We are urging for this review, subsequent implementation of this body and approval of abiraterone for non-metastatic men to be conducted quickly to ensure men are able to access potentially life-saving treatment like their UK peers,” the charity said.

At a glance

• Men in Northern Ireland cannot access the prostate cancer drug abiraterone for certain high-risk cases

• The drug is already available to patients in England, Scotland and Wales.

• Research shows the treatment can halve recurrence rates and reduce the risk of death by 40%.

• North Antrim MP Jim Allister raised the issue after being contacted by a constituent.

• Campaign group Prostate Cancer UK says hundreds of lives could be saved over the next five years.

• Northern Ireland lacks a medicines assessment body equivalent to those in the rest of the UK.

• Health Minister Mike Nesbitt says a review of medicines access arrangements is underway.

• Campaigners are urging Stormont to act quickly to end the “postcode lottery”.