Five medicines have been accepted by cost regulators for routine use on the NHS in Scotland, offering patients access to new options for lung cancer, multiple myeloma, opioid-induced constipation and the chronic skin condition rosacea. 

The Scottish Medicines Consortium has endorsed Celgene’s Revlimid (lenalidomide) for the treatment of patients newly diagnosed with multiple myeloma who are not eligible for stem cell transplant and not suitable for treatment with thalidomide. 

During the appraisals process, patient groups and clinicians spoke about the drug’s potential to improve length of life and increase patients’ ability to do normal daily activities with their families, as well as reducing the burden on carers, and the SMC also noted that there are very few effective treatment options for people who are unsuitable for thalidomide.

Novartis’ Zykadia (ceritinib) was recommended for patients with advanced, ALK-positive non-small cell lung cancer (NSCLC) who have not responded to treatment with Pfizer’s Xalkori (crizotinib), offering the only targeted option for this group of patients.  

According to the SMC, Zykadia may help improve overall survival, but NICE recently rejected the drug’s use on the NHS in England and Wales, because “the extent of treatment benefit was highly uncertain”, illustrating the postcode lottery of care.

Elsewhere, AstraZeneca’s Iressa (gefitinib) was also accepted as a treatment for advanced NSCLC in patients whose cancer cells have a gene defect that makes a protein called epidermal-growth-factor receptor (EGFR), offering another treatment option.

The cost regulator also waved through AZ’ Moventig (naloxegol) for the treatment of constipation caused by analgesics opioids. This common side effect of opioids is very difficult to treat; the drug offers another option for patients who have not responded to other therapies.

Also accepted was Galderma’s Soolantra (ivermectin) to treat skin lesions which can occur in rosacea, a chronic inflammatory skin condition. The drug can be used for patients who have moderate-to-severe inflammatory lesions.

On the downside, the Committee rejected AbbVie’s Duodopa (co-careldopa) intestinal gel for the treatment of patients with advanced Parkinson’s disease, because of too much uncertainty about the clinical benefits in relation to its cost.