NHS Scotland's November 2018 Funding Decisions

Nicky Broyd

November 12, 2018

A drug to treat a rare cancer in very young children was the only medicine accepted for routine use by NHS Scotland in the Scottish Medicines Consortium's (SMC) November 2018 decisions.

Neuroblastoma

Dinutuximab beta (Qarziba, Eusa Pharma UK) has been accepted by the SMC to treat neuroblastoma, a nerve cell cancer with a high mortality rate that is predominantly diagnosed in young children.

Consideration through the SMC’s Patient and Clinician Engagement (PACE) process for end of life and very rare conditions led to acceptance of dinutuximab.

The PACE meeting heard how children with neuroblastoma can experience nausea and vomiting, bone pain, weight loss, bleeding, kidney damage, breathing problems and spinal compression leading to paralysis, with tumours occurring in the neck, chest, abdomen or pelvis.

The SMC says dinutuximab can improve survival and may offer the potential for a more normal childhood.

SMC Chairman Dr Alan MacDonald said in a news release: "I am pleased the committee has been able to accept dinutuximab for the treatment of neuroblastoma. Patients and clinicians who took part in our PACE meeting told us how devastating this condition can be for young children and their families, so we hope this will be a welcome decision."

Bladder Cancer

The SMC did not accept atezolizumab (Tecentriq, Genentech/Roche) for bladder cancer in patients who have already undergone chemotherapy. It was also not recommended after consideration through the PACE process despite the additional flexibility the process allows.

Dr MacDonald said: "We were unable to accept atezolizumab as the company’s evidence about the clinical and cost effectiveness of the medicine was not strong enough."

Multiple Sclerosis

Also not recommended were fampridine tablets (Fampyra, Biogen Idec Ltd) for the improvement of walking in adults with multiple sclerosis (MS) and walking disability.

Dr MacDonald said: "For fampridine, the committee did not recommend the medicine as there was too much uncertainty in the company’s evidence about its cost effectiveness."

Fampridine is also not recommended for use on the NHS in England and Wales.

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