Esomeprazole and fondaparinux accepted for use in NHS Scotland
Esomeprazole (Nexium) and fondaparinux (Arixtra) are both given the green light for use in Scotland this month as part of the Scottish Medicines Consortium’s latest guidance. Esomeprazole is endorsed for treatment
of Zollinger-Ellison Syndrome, although the SMC does point out that other
cheaper proton pump inhibitors are available. Fondaparinux gains approval
for the treatment of unstable angina or non-ST segment elevation myocardial
infarction in patients for whom urgent invasive management is not indicated.
Restricted use is granted to tiotropium Respimat inhaler (Spiriva-Respimat)
and topotecan (Hycamtin). Spiriva-Respimat should only be used for patients
who have difficulty using the Handihaler device because of poor manual
dexterity. Hycamtin is accepted for use in combination with cisplatin
for patients with carcinoma of the cervix recurrent after radiotherapy
and for patients with stage IVB disease. It is restricted to patients
who have had no previous exposure to cisplatin.
One product failed to get through the SMC’s assessment process
on economic grounds — sevelamer hydrochloride (Renagel) is not
recommended for use for control of hyperphosphataemia in adult patients
receiving peritoneal dialysis.
The bulk of this month’s advice is taken up with products that
are not recommended due to manufacturers not making submissions to the
SMC. These were Alexion’s eculizumab (Soliris) for paroxysmal nocturnal
haemoglobinuria, GlaxoSmithKline’s fosamprenavir (Telzir) for treatment
of HIV-infected adolescents and children, Roche’s bevacizumab (Avastin)
for first-line treatment of unresectable advanced, metastatic or recurrent
non-small cell lung cancer, Procter & Gamble’s risedronate
(Actonel) for osteoporosis in men at high risk of fractures and Novartis’s
imatinib (Glivec) for a number of indications, including newly diagnosed
Philadelphia chromosome positive acute lymphoblastic leukaemia, both
as monotherapy and in combination with chemotherapy.
Details of the decisions are available on the SMC
website
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