NHS Scotland's March 2020 Funding Decisions

Nicky Broyd

March 10, 2020

The Scottish Medicines Consortium (SMC) has approved medicines for lung cancer, ovarian cancer, and leukaemia, but turned down a myotonia treatment.

The decisions were all made after referral to its Patient and Clinician Engagement (PACE) process, for rare conditions and end of life use.

NSCLC

Lorlatinib (Lorviqua, Pfizer) was given interim approval for ALK-positive non-small cell lung cancer (NSCLC) where patients have not responded to previous treatments.

The SMC said lorlatinib may extend the time before the cancer returns and improve overall survival.

Dr Mark MacGregor SMC co-vice chair said in a statement: Our decision to accept lorlatinib on an interim basis means that those with ALK-positive NSCLC will be able to access treatment while further data are gathered on the benefits of this medicine."

The decision was welcomed by Paula Chadwick, Roy Castle Lung Cancer Foundation's chief executive. In a news release, she said: "Many patients already benefit from targeted therapies, so the arrival of a further treatment option is yet another significant advance in tackling ALK-positive NSCLC.

"It’s good news, as it offers another line of treatment for people living with this specific type of lung cancer. It means that now even more people can expect to live better for longer."

Ovarian Cancer

Rucaparib (Rubraca, Clovis Oncology) was approved as a maintenance treatment for recurring ovarian cancer where BRCA negative patients had responded to treatment with platinum-based cancer medicines.

The SMC said rucaparib, taken orally, can extend relapse-free time between rounds of chemotherapy.

Dr MacGregor said, for patients: "Rucaparib provides a maintenance treatment that can increase the time until they need further chemotherapy. From the evidence given by patients and clinicians in our PACE meeting for this medicine, we know our decision will be welcomed."

ALL

Blinatumomab (Blincyto, Amgen) was approved for Philadelphia-chromosome-negative CD19-positive B-precursor acute lymphoblastic leukaemia (ALL).

The new advice extends 2016 recommendations to allow use earlier than before.

Dr MacGregor said: "The decision for blinatumomab offers patients with ALL not only an earlier treatment for their condition but for some it may provide a bridge to bone marrow transplant."

Myotonia

Mexiletine (Namuscla, Lupin Healthcare) was not approved for myotonia in patients with non-dystrophic myotonic disorders.

Dr MacGregor commented: "Although our PACE process allows committee members additional flexibility in their decision making, they were unable to accept mexiletine for the treatment of symptoms of myotonia as the company’s evidence on the benefits of the medicine were not clear."

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