NHS Scotland's January 2019 Funding Decisions

Nicky Broyd

January 14, 2019

The Scottish Medicines Consortium (SMC) has this month approved a drug to treat advanced breast cancer, as well as drugs for type-2 diabetes and one to treat psoriatic arthritis.

Advanced Breast Cancer

Pertuzumab (Perjeta, Roche) has been approved by the SMC for use in the treatment of HER2 positive metastatic breast cancer or locally recurrent unresectable breast cancer. It had previously been accepted for a particular type of early stage breast cancer prior to surgery.

It was accepted for use in NHS Scotland following consideration through its Patient and Clinician Engagement (PACE) process for medicines used at the end of life and for very rare conditions. It is used in combination with trastuzumab (Herceptin, Roche) and docetaxel (Taxotere, Pfizer).

A Roche press release estimates 983 patients per year in Scotland could be eligible to receive the drug in the metastatic indication.

SMC Chairman Dr Alan MacDonald said: "We are pleased to be able to accept pertuzumab for the treatment of HER2 positive metastatic breast cancer or locally recurrent unresectable breast cancer. We know from the testimonies given through our PACE process how devastating this condition is for patients and their families, and we hope this decision, which offers the opportunity of extra time when the patient feels well, will be welcomed by them."

Psoriatic Arthritis 

Tofacitinib (Xeljanz, Pfizer) was accepted for the treatment of psoriatic arthritis. It offers an alternative to patients who have not responded to previous therapies. 

Dr MacDonald said: "For patients with psoriatic arthritis, tofacitinib is a useful addition to the range of therapies that can be used to treat their condition."

Type 2 Diabetes

Ertugliflozin (Steglatro, Merck) and semaglutide (Ozempic, Novo Nordisk) were both accepted for use in NHS Scotland for patients with type 2 diabetes as part of a package of treatment that includes diet and exercise.

Dr MacDonald said: "Ertugliflozin and semaglutide provide other helpful treatment options for those with diabetes mellitus."


Not approved for use in NHS Scotland was the chemotherapy drug arsenic trioxide (ATO) (Trisenox, Teva) for the treatment of acute promyelocytic leukaemia (APL). The SMC committee said it was unable to accept it because there was too much uncertainty in the evidence submitted by the company about its benefits.

Dr MacDonald said: "The committee was unable to accept arsenic trioxide for acute promyelocytic leukaemia as the evidence provided by the company was not strong enough."


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