SMC accepts three new medicines for use by NHSScotland

The Scottish Medicines Consortium (SMC), has today published advice accepting three new medicines for use by NHSScotland.

Olaratumab (Lartruvo) was accepted for the treatment of advanced soft tissue sarcoma, a rare type of cancer that affects the soft, supportive tissues of the body such as muscles, blood vessels and fat tissue. It is used in patients who cannot undergo curative surgery or radiotherapy. Olaratumab is given with doxorubicin (a chemotherapy medicine), and both medicines are given by intravenous infusion.   Through SMC’s Patient and Clinician Engagement (PACE) process for medicines used to treat very rare and end of life conditions, it was highlighted that sarcoma often occurs in younger patients who may have significant work and family commitments. Olaratumab can improve overall survival and PACE participants commented that treatment may give patients the ability to maintain a good quality of life.

Pegvisomant (Somavert) for the treatment of acromegaly was also accepted through the PACE process. Acromegaly is a rare condition usually caused by a non-cancerous tumour on the pituitary gland. In the PACE meeting, patient groups and clinicians spoke of how patients suffer significant symptoms, including extreme fatigue, joint pain and excess growth which can affect internal organs and external appearance. Pegvisomant provides a treatment option with a different side effect profile for patients where previous therapies have not been successful.  Some patients receive radiation therapy but it can take years for this to be fully effective and pegvisomant may reduce the signs and symptoms of acromegaly until the benefits of radiation are fully realised. 

Also accepted was glecaprevir / pibrentasivir (Maviret) for the treatment of chronic hepatitis C, a blood-borne virus that predominantly infects the cells of the liver, resulting in inflammation and significant damage and potentially liver failure or cancer. Glecaprevir / pibrentasivir is given as a short-term course of oral treatment which is associated with a high response rate and offers the prospect of a cure across all types of hepatitis C. 

Mercaptamine (Procysbi) for nephropathic (kidney) cystinosis was not recommended. This is an inherited disease in which excess amounts of cystine, an amino acid naturally found in the body, build up within cells, especially in the kidneys and the eyes, causing irreversible damage. The SMC Committee was unable to accept mercaptamine as the company’s evidence on the clinical and economic benefits of using the medicine was not strong enough when compared to the current treatment option. 

The committee was also unable to accept reslizumab (Cinqaero) to treat a particular type of asthma called eosinophilic asthma. Reslizumab is an intravenous infusion which is added to standard inhaled treatment in adults with severe asthma. The committee was unable to accept reslizumab as it was not satisfied about its cost effectiveness in relation to other similar preparations. 

SMC Chairman Dr Alan MacDonald said:

“We are pleased to be able to accept these three medicines for use by NHSScotland."

“From the information provided by patient groups and clinicians in the PACE meeting, we know that our decision on olaratumab (Lartruvo) will be welcomed, particularly as it helps patients maintain a good quality of life."

“Pegvisomant offers a helpful further treatment option for acromegaly in those patients who have not responded to current treatments." 

“As the first medicine we have been able to accept for treatment across all types of hepatitis C, glecaprevir / pibrentasivir is a welcome addition and supports the aim of both Scottish Government and the World Health Organisation to eradicate this virus.”

 “We were unable to accept mercaptamine for nephropathic cystosis as the evidence provided by the company on the clinical and economic benefits of using this medicine instead of the current treatment option was not strong enough to justify the additional costs.”

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