Cost regulators have approved the use of four new medicines for use by NHS Scotland, including a new option for Parkinson's disease and asthma, but rejected Sanofi-Genzyme's Jevtana for prostate cancer and Amgen's Repatha for high cholesterol.

The Scottish Medicines Consortium has now accepted AbbVie's gel Duodopa (co-careldopa) for use in patients with advanced Parkinson's disease when alternative medical options have been unsuccessful.

The gel, which was originally turned down by the SMC, is administered via a pump and tubing which has to be surgically inserted into the gut. According to patient groups and clinicians taking part in the agency's PACE process, co-careldopa gel, which would only be suitable for a small number of patients, can help to control symptoms of the disease.

Amgen's Blincyto (blinatumomab), which was also considered under PACE process for medicines that treat end of life and very rare conditions, will be funded for the rare and aggressive cancer acute lymphoblastic leukaemia (ALL).

The SMC heard from patient groups and clinicians that patients are often diagnosed in their mid to late thirties, when many have work and family commitments, but there is currently a lack of treatment options for this condition. Blincyto may also provide a bridge to bone marrow transplant for some patients.

Elsewhere, GlaxoSmithKline's biologic Nucala (mepolizumab) has been accepted for severe eosinophilic asthma (a type of asthma characterised by an excess of inflammatory cells known as eosinophils) which is not well controlled with previous treatments.

Finally, patients at risk of Tumour Lysis Syndrome (TLS), a complication due to the breakdown of cancer cells leading to a rise in uric acid level in the blood which can then cause kidney damage, can now get access to Menarini Pharmaceutical's Adenuric (febuxostat), offering another treatment option to patients intolerant or resistant to current options.

On the downside, the Committee was unable to accept Jevtana (cabazitaxe), a chemotherapy for advanced prostate cancer, concluding that the overall health benefits of the medicine were not sufficient to justify the cost to the NHS. However, the company has indicated its intended to resubmit the drug, the cost watchdog noted. Jevtana has been cleared by sister body the National Institute for Health and Care Excellence for use in England. 

Repatha (evolocumab) was also ousted. While conceding that the drug reduces high cholesterol levels, the Committee felt the lack of evidence about the long-term clinical benefits it can bring in relation to its cost, meant it was not a good use of NHS resources.

The drug, the world's first approved PCSK9 inhibitor, also recently won a reprieve from NICE, which is now supporting its use on the NHS in England and Wales in various scenarios.