January 2019 decisions news release

A medicine used to treat advanced breast cancer has today (Monday 14 January) been accepted by the Scottish Medicines Consortium (SMC) for use in NHSScotland.

Pertuzumab (Perjeta) can be used for the treatment of HER2 positive metastatic breast cancer (cancer that has spread to other parts of the body) or locally recurrent unresectable breast cancer (cancer that has come back locally after treatment and cannot be removed by surgery). This is a fatal and aggressive sub-type of breast cancer, and the outlook at this stage of the disease is very poor. In these cases, pertuzumab is used in combination with trastuzumab and docetaxel (other cancer medicines). Pertuzumab was accepted following consideration through the SMC’s Patient and Clinician Engagement (PACE) process for medicines used at the end of life and for very rare conditions. In the PACE meeting, patient groups and clinicians spoke of this type of breast cancer commonly affecting younger women at a stage in their lives where they often have responsibility for young families, have significant work commitments or may be carers for elderly parents. Pertuzumab improves overall survival, offering women improved quality of life and valuable extra time with their families. 

Tofacitinib (Xeljanz) was accepted for the treatment of psoriatic arthritis, a painful and debilitating condition which causes red scaly patches on the skin and inflammation of the joints. Psoriatic arthritis can cause stiffness, pain and lack of movement in affected joints which can be irreversible and lead to disability. The condition also has a significant psychological impact on patients, many of whom will be of working age. Tofacitinib offers another treatment option for patients who have not responded to previous therapies. 

Ertugliflozin (Steglatro) was accepted for the treatment of type 2 diabetes as part of a package of treatment which includes diet and exercise to improve glycaemic control. Ertugliflozin offers patients with the condition another treatment option.

Semaglutide (Ozempic) was also accepted for the treatment of type 2 diabetes alongside a diet and exercise regime.

Arsenic trioxide for the treatment of acute promyelocytic leukaemia (APL), a very unusual form of leukaemia (cancer of the white blood cells) was not recommended. This rare condition can cause fatigue, chest pain and bleeding from the lining of the gut or in the brain. The SMC Committee was unable to accept arsenic trioxide as there was too much uncertainty in the evidence submitted by the company about the benefits the medicine may bring. 

SMC Chairman Dr Alan MacDonald said:

“We are pleased to be able to accept pertuzumab for the treatment of HER2 positive metastatic breast cancer or locally recurrent unresectable breast cancer. We know from the testimonies given through our PACE process how devastating this condition is for patients and their families, and we hope this decision, which offers the opportunity of extra time when the patient feels well, will be welcomed by them.” 

“For patients with psoriatic arthritis, tofacitinib is a useful addition to the range of therapies that can be used to treat their condition.”

“Ertugliflozin and semaglutide provide other helpful treatment options for those with diabetes mellitus.”

“The committee was unable to accept arsenic trioxide for acute promyelocytic leukaemia as the evidence provided by the company was not strong enough.”

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