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The company behind a life-extending prostate cancer drug said they are "disappointed" by the decision not to extend its availability in NHS England.
Abiraterone will continue to be available only to those who have already undergone chemotherapy, Nice, the health service financial watchdog, ruled.
Dr Peter Barnes, medical director at Janssen, who manufacture the drug, said the decision will leave suffers no option but to accept chemotherapy "they may not necessarily need or want yet."
Nice said the drug is "not cost effective at its current price."
The decision by the NHS financial watchdog Nice not to offer a life-extending prostate cancer drug to sufferers in England until after they have undergone chemotherapy is "a fiasco", a leading charity said.
Prostate Cancer UK's chief executive Owen Sharp said that the ruling robs patients of the chance to delay chemotherapy and its severe side effects.
A life-extending prostate cancer drug will continue to only be available to sufferers who have already undergone chemotherapy, the NHS financial watchdog said.
In final draft guidance reassessing the use in the NHS in England of abiraterone, the National Institute for Health and Care Excellence (Nice) ruled that to extend the availability of the drug was "not cost effective at its current price."
There is "clear evidence" that the use of abiraterone before chemotherapy gives patients "longer healthier lives," according to The Institute of Cancer Research, where the drug was discovered.
Nice's chief executive Sir Andrew Dillion said: "We know how important it is for patient to have the option to delay chemotherapy and its associated side affects, so we are disappointed not to be able to recommend abiraterone for use in this way.
"However, the manufacturer's own economic model demonstrated that the drug does not offer enough benefit to justify its price."
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