Scottish cost regulators have approved four new therapies for use on the National Health Service in Scotland, offering patients access to new treatments for skin cancer, ovarian cancer and deep vein thrombosis.

First up, the SMC has issued a positive recommendation for MSD’s immunotherapy Keytruda (pembrolizumab) as a treatment option for patients with advanced melanoma who have not been previously treated with Bristol Myers Squibb’s Yervoy (ipilimumab).

Scotland has one of the highest incidence rates of malignant melanoma in the UK, with around 1,200 new cases diagnosed in 2011, and the SMC’s decision will bring the first anti-PD-1 inhibitor treatment option to patients. The regulator noted that Keytruda may delay the progression of skin cancer and also has different side effects to existing medicines.

On the downside, the drug was turned down as monotherapy for advanced melanoma in adults previously treated with Yervoy, because a sufficiently robust economic analysis wasn’t presented by the company, the SMC said.

Roche’s Avastin (bevacizumab) was also accepted following a resubmission for use in combination with chemotherapy as an initial treatment for patients with advanced ovarian cancer. Patient groups and clinicians highlighted the lack of treatment options for patients, and that no other new medicines had been developed in the past 10 years for use at this stage of the condition.

Daiichi Sankyo’s bloodthinner Lixiana (edoxaban) was endorsed for the treatment of deep vein thrombosis and pulmonary embolism, as well as for the prevention of stroke in patients with atrial fibrillation (a kind of irregularity of the heart beat), offering patients a new option with potential advantages over veteran anticoagulant warfarin.

“Many patients are on warfarin which needs to be dose adjusted dependent on the INR blood levels which require regular monitoring. It also interacts with many foods and medicines,” the SMC said, noting that Lixiana “would provide patients with another oral anticoagulation option which may impact positively on their day to day, social and working lives as it is a once daily dose and does not require any regular monitoring. In addition, it does not need significant adjustments to diet and lifestyle”.