The Scottish Medicines Consortium (SMC), which advises on newly licensed medicines for use by NHSScotland, has published advice accepting four new medicines in October.
The Scottish Medicines Consortium (SMC) is the national source of advice on the clinical and cost-effectiveness of all new medicines for NHSScotland. They aim to ensure that people in Scotland have timely access to medicines that provide the most benefit based on best available evidence.
Gemtuzumab ozogamicin (Mylotarg) was accepted for the treatment of acute myeloid leukaemia (AML) following consideration through the SMC’s Patient and Clinician Engagement (PACE) process, which is used for medicines that treat end of life and very rare conditions. Gemtuzumab ozogamicin is added to standard chemotherapy and can prolong the period before relapse and the time to further chemotherapy, allowing patients significant additional time with a better quality of life.
Anakinra (Kineret) was accepted for the treatment of Still’s disease, a rare type of inflammatory arthritis that is similar to rheumatoid arthritis. Still’s disease may begin during childhood as Systemic Juvenile Idiopathic Arthritis or in adulthood as Adult Onset Still’s Disease. Anakinra provides a useful additional treatment option for patients with Still’s disease, potentially improving their quality of life.
Hydrocortisone (Alkindi) was accepted for the treatment of adrenal insufficiency in infants, children and adolescents. Patients with this condition cannot produce enough of a hormone called cortisol in their adrenal glands. This new formulation offers more accurate dosing and is tasteless, meaning it is likely to be easier for parents and carers to administer.
Also accepted was ixekizumab (Taltz), a bioengineered protein (biologic) therapy for psoriatic arthritis, an inflammatory joint disorder associated with the skin disease psoriasis. Psoriatic arthritis usually develops between the ages of 30 and 50, causing stiffness, pain and lack of movement in affected joints which can be irreversible and lead to disability. Ixekizumab offers another option for those patients who have not responded to previous conventional and biologic therapies.
The committee was unable to accept cabozantinib (Cabometyx) for advanced renal cell carcinoma (kidney cancer). Despite the additional flexibility the PACE process allows, the committee was unable to recommend cabozantinib as there was too much uncertainty in the company’s evidence around the cost-effectiveness of the medicine compared to the treatment options already available in NHSScotland.
SMC Chairman Dr Alan MacDonald commented:
“The committee is pleased to be able to accept these four new medicines for use by NHSScotland. Through the PACE meeting, we heard clearly how patients with AML have to endure significant symptoms from a condition for which there have been no new treatments for almost 30 years. We hope our decision on gemtuzumab ozogamicin will be of benefit to patients by allowing the opportunity for a period of significant additional time in remission when the quality of life is not reduced by disease symptoms or side-effects of chemotherapy. For those with Still’s disease, anakinra is a helpful additional treatment option which may improve their quality of life.
“The new formulation of hydrocortisone intended specifically for infants, children and adolescents with adrenal insufficiency will hopefully make treatment easier to administer and adhere to for both patients and their carers. New therapies for psoriatic arthritis are always welcome, and ixekizumab offers another option for those patients who have not responded to previous treatments. Unfortunately, we were unable to accept cabozantinib (Cabometyx) for advanced renal cell carcinoma as the company’s evidence about the cost-effectiveness of the medicine, when compared to other treatments currently in use, was not strong enough.”