Scotland rejects drugs for multiple sclerosis, Parkinson's disease and adrenocortical carcinoma
Natalizumab, a treatment for multiple sclerosis, has been rejected, along with rasagiline and mitotane, for use within NHS Scotland by the Scottish
Medicines Consortium.
The SMC concedes that natalizumab (Tysabri) reduces relapse rates in
patients with rapidly evolving relapsing remitting multiple sclerosis
but says that the drug’s developer — Biogen Idec Ltd — failed
to demonstrate natalizumab’s cost effectiveness.
Likewise, the economic cases for rasagiline (Azilect), both as monotherapy
and as adjunct therapy (with levodopa) for the treatment of Parkinson’s
disease, and for mitotane (Lysodren), as symptomatic treatment of advanced
adrenocortical carcinoma, have not been demonstrated.
The SMC endorsed seven drugs in its December round of assessments. Five
of the drugs have restrictions on their use. These are:
• Dorzolomide with timolol (Cosopt) for elevated intra-ocular pressure
in patients with open-angle glaucoma and pseudo-exfoliative glaucoma
when topical beta-blocker use alone is not sufficient. Use is restricted
to patients for whom a combination product is appropriate and who have
proven sensitivity to benzalkonium chloride.
• Gemcitabine (Gemzar), in combination with paclitaxel, for patients
with metastatic breast cancer who have relapsed following chemotherapy.
Prior chemotherapy should have included an anthracycline. For this indication
gemcitabine use is restricted to oncologists specialising in breast cancer.
• Temozolomide (Temodal) for newly diagnosed glioblastoma multiforme
given at the same time as undergoing radiotherapy, and subsequently as
monotherapy. Use is restricted to patients who have had a partial or
complete macroscopic resection of their tumour.
• Rituximab (MabThera) as a maintenance therapy for patients with relapsed/refractory
follicular lymphoma. Use is restricted to oncologists or haematologists
who have expertise in treating lymphoma.
• Adalimumab (Humira) for adults with severe active ankylosing spondylitis
who have an inadequate response to conventional therapy. Use should be
in accordance with the British Society for Rheumatology guidelines of
July 2004.
Also approved are methotrexate injection (Metoject) for treatment of
severe active rheumatoid arthritis in adults for whom parenteral treatment
is appropriate and triptorelin 11.25mg vial for injection (Decapeptyl
SR) for the treatment of precocious puberty. |
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Pharmaceutical Journal
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