SMC recommends letrozole but rejects five others
Letrozole (Femara) was recommended for use in NHS Scotland this week by the Scottish
Medicines Consortium. However, it rejected a number of other drugs.
The SMC published the results of seven assessments this week. It recommended
that letrozole is accepted for the treatment of invasive early breast
cancer in postmenopausal women who have already received standard tamoxifen
therapy. Bivalirudin (Angiox) was recommended for restricted use as an
anticoagulant for patients undergoing percutaneous coronary intervention.
The SMC says that bivalirudin should be considered as an alternative
to treatment with unfractionated heparin in combination with a glycoprotein
llb/llla antagonist but not as an alternative to unfractionated heparin
alone.
However, gemcitabine in combination with paclitaxel (Gemzar), failed
to get SMC recommendation for the treatment of metastatic breast cancer
on the grounds that the economic case had not been demonstrated. Cetuximab
(Erbitux) also did not receive SMC recommendation on grounds of cost-effectiveness.
It was being considered for treating, in combination with irinotecan,
colorectal cancer after failure of cytotoxic therapy.
Slow-release metformin (Glucophage SR) failed to get SMC recommendation
for treating type 2 diabetes because it did not demonstrate benefits
in terms of efficacy or side effects over immediate-release metformin
and was more expensive. Also rejected were pregabalin (Lyrica) for the
treatment of peripheral neuropathic pain on the grounds of clinical and
cost-effectiveness not being demonstrated, and atomoxetine (Strattera)
for treatment of attention deficit disorder because the economic case
had not been demonstrated. |
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