The Pharmaceutical Journal
Vol 276 No 7384 p64
21 January 2006

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News summary

SMC accepts antihistamine eye-drop and dispersible PPI but rejects four other drugs

A new antihistamine eye drop and an oro-dispersible form of lansoprazole have been accepted by the Scottish Medicines Consortium for use within NHS Scotland. Four drugs were rejected for economic reasons.

Olopatadine (Opatanol) — a locally applied antihistamine — has been accepted for the treatment of ocular signs and symptoms of seasonal allergic conjunctivitis. “It appears to have similar efficacy to other preparations for seasonal allergic conjunctivitis with a lower price than some,” says the SMC. Lansoprazole oro-dispersible tablets (Zoton FasTab) have also been accepted for use, in combination with appropriate antibiotics, to eradicate Helicobacter pylori.

Tipranavir (Aptivus), for the treatment of HIV-1 infection in highly pre-treated adult patients with virus resistant to multiple protease inhibitors, was launched in November 2005. Following its assessment, the SMC has concluded that tipranavir is more expensive than other protease inhibitors and says that the economic case for its use has not been demonstrated.

Bevacizumab (Avastin) was also rejected. Although in combination with standard regimens it improves overall survival times, its cost-effectiveness has not been proven. Its use for the first-line treatment of patients with metastatic cancer of the colon or rectum is therefore not recommended within NHS Scotland.

The SMC did not recommend a prolonged release form of metformin (Glucophage SR) on the grounds that its short-term efficacy is similar to immediate-release metformin and there is no convincing evidence that it has improved gastrointestinal tolerability. It is also more expensive than regular metformin.

Estradiol 1mg/drospirenone 2mg (Angeliq) for the prevention of osteoporosis in postmenopausal women at high risk of future fracture who are intolerant of, or have contraindications to, other drugs for this indication, was also rejected by the SMC. Although it maintains bone mineral density compared with placebo, no evidence of its cost-effectiveness has been presented, says the SMC.