The Scottish Medicines Consortium (SMC), which advises on newly licensed medicines for use by NHSScotland, has today (Monday 13 September 2021) published advice accepting three new medicines.
Selpercatinib (Retsevmo) was accepted for interim use subject to ongoing evaluation and future reassessment for the treatment of rare, thyroid cancers with a specific type of genetic change. The medicine was considered through SMC’s Patient and Clinician Engagement (PACE) process, which is used for medicines for end of life and rare conditions. In the PACE meeting, participants highlighted that patients experience disabling symptoms such as pain, incapacitating breathlessness and cough. There are currently limited treatment options. In patients who respond to treatment, selpercatinib is expected to reduce the symptom burden leading to improvements in quality of life. Selpercatinib is administered orally so is convenient for patients. The committee accepted selpercatinib on an interim basis and will consider further evidence on its effectiveness once this is available. Further information on interim acceptance is available.
Pembrolizumab (Keytruda) was accepted for the treatment of colon and rectum cancer that has certain genetic changes. Pembrolizumab is an immunotherapy (a type of cancer treatment that boosts the body’s natural defences to fight cancer). It may increase the time until disease progression compared with chemotherapy, allowing patients to have better quality time with their families. Patients may also experience fewer side effects from pembrolizumab compared to the current treatments.
The committee also accepted filgotinib (Jyseleca) for the treatment of severe rheumatoid arthritis in cases where other treatments have failed or could not be tolerated. Filgotinib provides another oral treatment option for patients with this condition and may help delay the progression of the disease and prolong the time patients can continue to work and live independently.
The committee was unable to accept amikacin liposoma as an add-on treatment for a chronic bacterial lung infection as the company’s evidence around the cost benefits was not strong enough.
The committee was also unable to accept mercaptamine (Procysbi) for use in patients with nephropathic cystinosis, a rare, inherited condition in which excess cysteine – an amino acid – builds up within cells, including the kidneys. This new formulation was not recommended as the company’s evidence was not strong enough to satisfy the committee that it offers value for money to NHSScotland when compared to the current treatment option.
SMC chairman Mark MacGregor said:
“The committee is pleased to be able to accept these three medicines for use by NHSScotland.”
“Participants in our PACE meeting told us of the heavy symptom burden for patients living with rare thyroid cancers. We hope that selpercatinib will lead to a reduction in these disabling symptoms, allowing patients to have more freedom to participate in family life and daily activities.”
“For patients with colon and rectum cancer, pembrolizumab is expected to increase time until the disease progresses, giving patients more quality time with family.”
“For those with severe rheumatoid arthritis, our decision on filgotinib provides another oral treatment option if they have not responded to current treatments.”
“We were unable to accept the new formulations of amikacin and mercaptamine as the evidence provided by the companies on the benefits of using these medicines instead of the current treatment options was not strong enough to justify the additional costs.”
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