Scottish cost regulators have approved funding for five new therapies on the NHS, offering new treatment options for a range of conditions.
Shire’s Revestive (teduglutide) was accepted for the treatment of paediatric onset short bowel syndrome (SBS) in children aged one – 17 years.
SBS is an extremely rare, chronic condition relating to a reduced ability to absorb nutrients in the intestine. Patients need intravenous nutrition through a catheter that lasts for many hours across several days of the week, which can cause complications such as catheter-related infections.
Revestive is a glucagon-like peptide-2 (GLP-2) analogue licensed for treating patients in a stable condition after their intestine has adapted post-surgery. The drug is designed to improve the absorption of nutrients and fluid from the remaining gastrointestinal tract and enhances key structural and functional adaptations in the intestinal mucosa.
Through SMC’s Patient and Clinician Engagement (PACE) process for medicines used to treat very rare and end of life conditions, it was highlighted that the drug can reduce the level of parenteral nutrition required by patients, improving quality of life.
NICE issued draft guidelines in November last year rejecting NHS funding for Revestive, after calculating its cost effectiveness to be around £193,549 per quality-adjusted life year (QALY) gained in adults.
The SMC also approved funding for two medicines targeting hepatitis C.
Gilead’s pan-genotypic therapy Vosevi (sofosbuvir-velpatasvir-voxilaprevir) was accepted for the treatment of hepatitis C in adults who have failed to respond to previous treatment with targeted anti-viral therapy. It was also endorsed for use in adults with hepatitis C genotype 3 who have not been treated with targeted antiviral therapy.
Gilead’s Epclusa (sofosbuvir-velpatasvir) was also recommended for the treatment of hepatitis C in patients with genotype 1 or 4 infection, which means that drug is now available in Scotland on the NHS for the treatment of patients with all hepatitis C genotypes.
Sanofi’s Kevzara (sarilumab) was accepted for the treatment of rheumatoid arthritis, offering a further treatment option for adults with severe disease who have not responded to or are intolerant of standard therapies.
The drug is a human monoclonal antibody that binds to the interleukin-6 receptor (IL-6R), and has been shown to inhibit IL-6R mediated signaling. In excess and over time, IL-6 can contribute to the inflammation associated with RA.