December 2018 decisions news release

A medicine used to treat early stage breast cancer has been accepted by the Scottish Medicines Consortium (SMC) for use in NHSScotland.

Pertuzumab (Perjeta), which is used in combination with trastuzumab and chemotherapy to treat a particular type of breast cancer at an early stage and prior to surgery, was accepted following consideration through SMC’s Patient and Clinician Engagement (PACE) process, for medicines used at the end of life and for very rare conditions. In the PACE meeting, patient groups and clinicians highlighted that this type of breast cancer has high rates of recurrence and poor survival. Pertuzumab may reduce the risk of recurrence and offer improved chance of longer term survival.

Also accepted was nivolumab (Opdivo) for advanced melanoma (a form of skin cancer). Currently at this stage of the condition, patients have routine checks and scans at clinic but there is no active treatment available. Through a patient group submission, MASScot told SMC that affected patients may have a reasonable quality of life at this stage but can be constantly worried about what will happen next. Nivolumab provides the opportunity of extended time until the disease returns, which may in turn offer patients psychological reassurance.

Ocrelizumab (Ocrevus) was accepted for treatment of relapsing remitting multiple sclerosis (MS). MS is an inflammatory disease of the nervous system that causes symptoms such as weakness, difficulty walking and problems with vision. Those with relapsing remitting MS experience periods when symptoms flare up (relapsing) followed by periods of good or complete recovery (remitting). Ocrelizumab offers another disease modifying therapy treatment option that may reduce both the rate of relapses and the progression of disability.

The committee also accepted ciclosporin (Verkazia) eye drops for severe vernal keratoconjunctivitis (VKC) in children and teenagers. VKC is a rare, chronic inflammatory allergic condition that affects the eye and mostly occurs seasonally, although in some patients symptoms can recur or persist all year round. Ciclosporin moderates the allergic response and inflammation associated with VKC.

SMC Chairman Dr Alan MacDonald said:

“I am pleased the committee has been able to accept pertuzumab for the treatment of early stage breast cancer prior to surgery. We know that a diagnosis of breast cancer can be devastating for patients and their families alike, so we hope this decision will be welcomed by those at this stage of the disease.”

“Nivolumab offers a treatment for patients currently relying on a “watch and wait” approach to monitor their melanoma. Having the reassurance of a treatment that may give them more time will support those at this stage of the condition.”

“For those with relapsing remitting MS, ocrelizumab is a useful addition to the range of disease modifying therapies that can be used to treat their condition.”

“Our decision on ciclosporin will provide an approved effective option for those with severe vernal keratoconjunctivitis.”

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