Scottish Medicines Consortium's August 2018 Decisions

Nicky Broyd

August 14, 2018

The Scottish Medicines Consortium (SMC) has published its latest funding decisions, with positive recommendations for medication for advanced ovarian cancer, a specific rare type of advanced non-small cell lung cancer, urea cycle disorders, and acute hereditary angioedema.

Positive Decisions

Niraparib (Zejula) was assessed through NHS Scotland's Patient and Clinician Engagement (PACE) scheme for rare conditions and end of life care.

Niraparib is the first maintenance treatment available for ovarian cancer patients who do not carry the BRCA mutation. The SMC says there's evidence niraparib helps delay relapses between chemotherapy treatments. It is prescribed in oral form for home use.

SMC Chairman Dr Alan MacDonald said: "Through the evidence given by PACE participants, we know that our decision on niraparib for ovarian cancer will be welcomed, particularly as it provides the first maintenance treatment for patients without the BRCA mutation."

Alectinib (Alecensa) was accepted to treat a rare and specific type of advanced non-small cell lung cancer (NSCLC). Treatment options are often limited when this cancer is diagnosed at a late stage and the SMC says alectinib has been shown to slow disease progression compared with existing treatment.

Dr MacDonald said: "For those with a specific type of NSCLC, alectinib can help delay the time to the progression of the disease, giving patients more opportunity to continue leading a normal life."

Glycerol phenylbutyrate (Ravicti) was accepted as a long-term treatment option for urea cycle disorders (UCDs) in adults and children (aged 2 months and over). This treatment helps to reduce ammonia levels in the body and may be an option if patients cannot tolerate current therapy.

Dr MacDonald said: "As a more palatable alternative to current treatments for urea cycle disorders, glycerol phenylbutyrate may make it easier for patients to adhere to treatment, particularly children."

Conestat alfa (Ruconest) was accepted as a treatment option for acute hereditary angioedema under the PACE scheme. The drug can to help reduce swelling during attacks.

Dr MacDonald said: "Conestat alfa offers a helpful additional option for those with the painful and unpredictable condition of acute hereditary angioedema."

Negative Decisions

Sapropterin (Kuvan) for phenylketonuria (PKU) was not accepted at this stage, but a meeting will take place with the manufacturer regarding the next steps for this treatment.

Dr MacDonald said that "the evidence provided by the company on the clinical and economic benefits of using this medicine was not clear enough to justify accepting it for use."

Patiromer (Veltassa) to reduce potassium levels in hyperkalaemia was not accepted.

Dr MacDonald said that "evidence provided by the company about the cost effectiveness of the medicine was not sufficiently strong."

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