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."
We are very disappointed with this decision which, if it stands, will leave thousands of men in England in the advanced stages of prostate cancer with no option but to accept chemotherapy - which they may not necessarily need or want yet - before being eligible to receive abiraterone routinely on the NHS.
These men will eventually be able to receive abiraterone on the NHS after chemotherapy anyway, but will be denied the option of taking it earlier on in their illness.