Cost regulators for National Health Service treatments in Scotland have approved five new medicines that will potentially benefit more than 5,000 patients with hepatitis C, skin cancer, kidney cancer and diabetes.

For diabetes, AstraZeneca’s once-daily DPP-4 inhibitor Onglyza (saxagliptin) has been accepted for use to improve blood glucose control in combination with insulin, while Bayer’s Eylea (aflibercept) can now be routinely used by the NHS to treat macular oedema, a loss of vision caused by a build up of fluid in the retina in patients with the disease.

The SMC also accepted Bristol-Myers Squibb’s once-daily pill Daklinza (daclatasvir) for treatment of the more severe types of chronic hepatitis C, which means that patients in Scotland are the first in Europe to routinely access this medicine through the health service. “These new direct-acting antiviral treatments may offer the prospect of cure for hepatitis C infection, which is associated with serious liver disease, among other complications, and is an important public health priority,” the group noted.

For cancer, Novartis’ Afinitor (everolimus) has been OK’d to treat renal cell carcinoma on the NHS in patients whose disease has progressed on or after treatment with vascular endothelial growth factor (VEGF)-targeted therapy, while B-MS’ immunotherapy Yervoy (ipilimumab) is in for first-line treatment of advanced melanoma.

On the down side, Roche’s metastatic breast cancer drug Perjeta (pertuzumab), resubmitted under new processes for orphan medicines, was rejected because estimates put its cost per QALY at around £125,000, and thus well above what is normally considered a cost-effective use of resources. 

“We know this decision will disappoint patients and clinicians alike as we understand the devastating impact of breast cancer,” said SMC chairman Jonathan Fox, but explained “we have to take account of the needs of all patients who need treatment”. 

NHS Scotland does not have infinite resources and companies are well aware of this,” he noted, and encouraged Roche to make a resubmission for Perjeta, “reflecting on the issues raised by SMC.”