New medicines for the treatment of HIV, asthma and MRSA-related skin infections have been endorsed by cost regulators for the National Health Service in Scotland.

The Scottish Medicines Consortium has put forward Janssen-Cilag’s Rezolsta (darunavir cobicistat) as an option, in combination with other antiretrovirals, for the treatment of HIV-1 infection in adults aged 18 years or older. 

Rezolsta combines the company’s big-selling HIV therapy Prezista (darunavir) and Gilead’s Tybost (cobicistat), offering an alternative for patients unable to tolerate the side effects of other treatments in a single pill, making it easier to manage and monitor treatment regimes, the regulator noted.

Janssen forecast the gross medicines budget impact to be £286,000 in year one and £1 million in year five, but, as other medicines were assumed to be displaced, the net medicines budget impact was estimated to be cost neutral.

New asthma option

The Committee also accepted Boehringer Ingelheim’s Spiriva Respimat (tiotropium) for the treatment of asthma. The drug is already used for chronic obstructive pulmonary disease and is now the first medicine in this class to be licensed for use in combination with other treatments in patients with severe, persistent, poorly controlled asthma, to boost lung function and reduce the risk of severe asthma attacks. 

The gross and net impact on the medicines budget is estimated to be £301,000 in year one and £4.3 million in year five.

Elsewhere, MSD’s once-daily antibiotic Sivextro (tedizolid phosphate) has been endorsed as a cost-effective option for the treatment acute bacterial skin infections and infections of the structures beneath the skin, including conditions such as cellulitis, skin abscesses and wound infections. 

But use of the drug has been restricted so that it should only be considered as an alternative oxazolidinone antibacterial on the specific advice of local microbiologists or specialists in infectious disease.

MSD estimates that around 40 patients will be eligible for treatment each year with an estimated uptake rate of 5% in year one and 45% in year five, and that the gross medicines budget impact will be £2,000 and £16,000, respectively. 

Halaven, Xtandi ousted

On the downside, the SMC said it was unable to recommend Eisai’s Halaven (eribulin) for breast cancer or Astellas’ Xtandi (enzalutamide) for castration-resistant prostate cancer, basically because their cost was too high in relation to their benefit.