The Pharmaceutical Journal
Vol 273 No 7322 p616
23 October 2004

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Success of Scottish Medicines Consortium

The 2004 British Pharmaceutical Conference and Exhibition “Medicines: from cell to society” took place at Manchester International Convention Centre from 27–29 September

BPC 2004 summary

The work of the Scottish Medicines Consortium was discussed by Angela Timoney, vice-chairman of the SMC and chairman of the Scottish Department of the Royal Pharmaceutical Society.

The SMC was established in October 2001 as a consortium of all the area drug and therapeutics committees from the NHS boards across Scotland, she explained. This aimed to address problems with duplication of work and variations in decisions between health boards.

It has a multidisciplinary membership of doctors, pharmacists, nurses, economists, lay and patient representatives, and a representative of the Association of the British Pharmaceutical Industry.

“It looks at three areas: all new chemical entities, new formulations and major new indications for existing drugs,” explained Ms Timoney. And importantly it advises NHS boards, not patients, on the use of medicinal products in NHS Scotland.

Three categories

The result of a review is to place a medicine in one of three categories: accepted for use, restricted use or not recommended for use. Examples of restrictions are to use the medicine as second-line therapy or for it to only be prescribed by a specialist only. So far, the SMC has reviewed 129 products. “Of these, 36 per cent were recommended for use, 39 per cent were recommended with restrictions and 25 per cent were not recommended,” Ms Timoney reported.

The process of review starts with the manufacturer submitting its evidence for a medicine. The product is then critically appraised, a preliminary decision is made, the manufacturer is given a chance to comment (but not to provide new evidence) and then the final advice is issued to health boards. “From submission of evidence to the SMC advice takes eight weeks,” said Ms Timoney.

“ Clinicians want this information when a drug is launched, that is why we try to get our advice out within six weeks of a launch.” This approach is different from that taken by the National Institute for Clinical Excellence which does not review new drugs until six months after launch. She added that SMC advice is made available to health boards initially and is then made public four weeks later. Another difference is that NICE came out of a government initiative which caused suspicion that it is about rationing, she commented.

“Pharmacists are involved at various stages,” she said. Six pharmacists are on the new drugs committee of the SMC and four pharmacists are on the main SMC committee. “One of the problems is that we have no community pharmacist members.” She hopes that this will be changed within five years.