SPEAKER_01: 0:00

Hello, and welcome again to The Bench Report. You're listening to Amy and Ivan. Today, we're going to look more closely at prostate cancer, its widespread impact, and also a specific treatment that really highlights a significant challenge in healthcare access right here in the UK. Let's just sort of lay out the scale of this first. We're talking one in eight men diagnosed in their lifetime.

SPEAKER_00: 0:25

That's huge.

SPEAKER_01: 0:27

It is. Over 50,000 men in the UK every single year. And that number, well, it's projected to double by 2040.

SPEAKER_00: 0:34

Double. Wow.

SPEAKER_01: 0:35

And while, you know, the most common age for diagnosis is 70 plus, over half of the men diagnosed are actually pre-retirement age.

SPEAKER_00: 0:42

Right. People still very much in the workforce contributing.

SPEAKER_01: 0:45

Exactly. Think of someone like the cyclist Sir Chris Hoy diagnosed almost at 48. Now, you often hear the saying that men tend to die with prostate cancer rather than of it.

SPEAKER_00: 0:54

Yes, that's a common perception.

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But as Dr. Ruppeheck shared about her late father, who battled it for a decade, that experience really underlines the profound impact it has on families regardless.

SPEAKER_00: 1:05

Absolutely. And on that note, there's been remarkable progress in treatment. A really crucial British medical success story is abiraterone, discovered and initially developed right here in London at the Institute of Cancer And this isn't just, you know, another medication. It has genuinely revolutionized advanced prostate cancer care.

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How so?

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Well, for about half a million men globally. It's transformed outcomes, significantly improved quality of life, and extended those precious years spent with loved ones. It even halves the risk of relapse.

SPEAKER_01: 1:39

Halves the risk. That's significant. So we have this incredible British-born breakthrough transforming lives. But here's the perplexing twist in the story. Despite its proven effectiveness, there's this striking inconsistency in access across the UK.

SPEAKER_00: 1:54

That's right.

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For men with non-metastatic prostate cancer, it's routinely available in the NHS in Scotland and Wales.

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But crucially... Not everywhere else. If you're a man in England or Northern Ireland, even with an identical diagnosis, you often cannot access abiraterone as a standard first-line treatment.

SPEAKER_01: 2:10

So it depends on your postcode.

SPEAKER_00: 2:12

Essentially, yes. Members of Parliament are calling it exactly that, a postcode lottery. Your health outcomes are tied to your address.

SPEAKER_01: 2:18

Okay, this seems bewildering. Let's talk about the money side of this. What's the financial reality of abiraterone now?

SPEAKER_00: 2:24

Well, this is key. Its original patent has expired, so it's now off-patent, which drastically cuts the cost.

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How much are we talking?

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Just£2.75 a day.

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£2.75 a

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day. And just for perspective, University College London actually calculated it would pay for itself even if it cost£11 a day.

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How would it pay for itself?

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Because of the savings down the line. Preventing costly relapses, fewer scans, avoiding expensive chemotherapy treatments later on.

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Two pounds 75 a day for a drug that extends lives and halves relapse risk, that seems almost unbelievable given its impact. So if it's that cheap and effective, why on earth is this disparity happening?

SPEAKER_00: 3:06

Well, that's the core insight here, isn't it? It boils down to bureaucracy, mostly. The drug isn't licensed by the MHRA, that's the Medicines and Healthcare Products Regulatory Agency, for this specific non-metastatic use. And because it's now a generic drug, there isn't one single manufacturer with the commercial incentive to actually sponsor that specific license application or push for a NICE evaluation.

SPEAKER_01: 3:29

NICE being the National Institute for Health and Care Excellence.

SPEAKER_00: 3:31

Exactly. Now, NHS England does acknowledge the clinical benefit. They see it works. But they say they haven't identified the necessary funding, about$20 million annually, to cover the estimated 7,000 eligible men for this specific purpose.

SPEAKER_01: 3:45

$20 million sounds like a lot, but compared to the potential savings.

SPEAKER_00: 3:48

Precisely. But they note those significant cost savings from preventing the cancer progressing, well, they'd take about five years to actually materialize on the books. So it's this bureaucratic cost-benefit paradox that unfortunately costs lives.

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And the consequences are severe. Prostate Cancer UK estimates around 672 men in England die prematurely each year because they can't access this drug.

SPEAKER_00: 4:11

That's about 13 men every single week. Men whose cancer could potentially have been treated cheaply, effectively, if they just lived, say, in Scotland or Wales.

SPEAKER_01: 4:19

13 men a week? That's staggering.

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It really is. And it raises a vital question for all of us. How do we make sure that medical breakthroughs, which are clinically effective and cost-effective, actually actually reach everyone who needs them, regardless of where they live or their financial situation.

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So what's being done?

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Well, members of parliament are pushing hard They're advocating for universal access to abiraterone for this group, introducing a national prostate cancer screening program, and demanding more transparent, timely decision-making from the health bodies involved.

SPEAKER_01: 4:53

And they're highlighting other disparities too, aren't they?

SPEAKER_00: 4:56

Yes. Crucially, the disproportionate effect prostate cancer has on black men. They're more likely to develop it, more likely to get a late diagnosis, and sadly, less likely to receive the right treatment on time. That needs urgent attention.

SPEAKER_01: 5:10

So there is some movement. NHS England is looking at new financial models.

SPEAKER_00: 5:15

They are, yes. They're reviewing proposals from groups like Prostate Cancer UK. And there's a national cancer strategy due this autumn. The stated aim is clear. Improve cancer care. Reduce the number of lives lost over the next 10 years.

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So as we've kind of explored today, sometimes the biggest hurdle for a medical breakthrough isn't the science itself. It's the system.

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Navigating the system.

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When a cheap life-extending drug faces these bureaucratic barriers for years, it really makes you question priorities. Are we truly putting lives ahead of ledgers? Something to think about, perhaps, as we look at the future of health care access. As always, find us on social media at Ventureport UK. Get in touch with any topic important to you.

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Remember, politics is everyone's business. Take care.