SMC recommends six medicines and rejects three
Guidance published this week by the Scottish
Medicines Consortium accepts six medicines for use within NHS Scotland
and rejects three.
Colon cancer: oxaliplatin endorsed |
Recommendations for use include oxaliplatin (Eloxatin),
in combination with fluorouracil and folinic acid, for the adjuvant
treatment of stage
III (Dukes C) colon cancer after surgery for the primary tumour. Palonosetron
(Aloxi) for the prevention of nausea and vomiting associated with highly
and moderately emetogenic chemotherapy is also accepted for use.
For patients with postmenopausal osteoporosis who are at risk of vitamin
D insufficiency who require treatment with both alendronate and vitamin
D, and for whom once weekly administration is appropriate, Fosavance
(alendronate 70mg and colecalciferol 2,800IU) is recommended by the SMC.
It says that using the combination product is cheaper than administering
the two drugs separately. Solifenacin (Vesicare) for symptomatic treatment
of urge incontinence and increased urinary frequency is also accepted.
However, the SMC notes that there are cheaper antimuscarinic drugs available
that would normally be used first line.
Exemestane (Aromasin) and etanercept (Enbrel) are accepted for restricted
use within NHS Scotland. Exemestane is accepted for the adjuvant treatment
of postmenopausal women with oestrogen receptor positive early invasive
breast cancer, following two to three years of adjuvant tamoxifen therapy.
Etanercept can be used in accordance with the British Society for Rheumatology
guidelines (2004) for adults with severe active ankylosing spondylitis
who have had an inadequate response to conventional therapy.
Docetaxel (Taxotere), in combination with prednisolone for the treatment
of metastatic hormone refractory prostate cancer, has not been recommended
by the SMC. It says that, although docetaxel offers improvements in survival,
pain control and quality of life, as well as a greater reduction in prostate
specific antigen levels, compared with the current standard chemotherapy
regimen, cost-effectiveness has not been demonstrated.
Diclofenac gel patch (Voltarol) for the symptomatic treatment of pain
in epicondylitis and ankle sprain is also rejected on the grounds of
its high cost compared with diclofenac gel. Cilostazol (Pletal) for improvement
of the maximal and pain-free walking distances for patients with intermittent
claudication who do not have evidence of peripheral tissue necrosis is
not recommended. Its efficacy and safety in patients who are concomitantly
treated with an antiplatelet drug is unclear, says the SMC. It adds that
the drug’s clinical- and cost-effectiveness have not been demonstrated. |
The
Pharmaceutical Journal
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