Good news for AstraZeneca came in the form of an approval by Scottish regulators for the use of its bloodthinner Brilique (ticagrelor) on the country's National Health Service in patients with heart problems.

The Scottish Medicines Consortium has agreed that Brilique should be funded for use in combination with aspirin in patients with acute coronary syndromes, i.e. those who have had a myocardial infarction or an episode of unstable angina.

In Scotland around 260,000 people are affected by angina and 140,000 have had a heart attack. Clinical trials have shown that a combination of Brilique and aspirin cut the risk of repeat cardiac events in comparison to the most commonly used therapy clopidogrel.

According to AstraZeneca, its drug demonstrated a 21% relative risk reduction in cardiovascular death, and 16% of repeat cardiovascular events were avoided when patients were given Brilique/aspirin instead of clopidogrel/aspirin following a heart attack or episode of unstable angina.

Welcoming the SMC's decision, Neal Uren, a cardiologist at the Royal Infirmary of Edinburgh noted that despite current treatment options nearly 15% of patients will die within 12 months following a heart attack.

He considers Brilique's approval "a great step forward for improving the care of heart attack patients in Scotland" as they will be the first in Britain to have "widespread access to a new treatment which is superior to the existing standard of care in reducing the combined chance of repeat cardiovascular events such as heart attack, stroke or death from cardiovascular causes”.

The National Institute for Health and Clinical Excellence is expected to reach a decision on the use of Brilique in patients with ACS on the NHS in England and Wales later this year. 

Sutent OK

Meanwhile, there was also good news for Pfizer after the SMC issued a green light for the use of its Sutent (sunitinib) in adult patients with unresectable or advanced pancreatic neuroendocrine tumours.

The regulator said that the drug improved progression free survival compared with placebo in patients with well-differentiated neuroendocrine carcinoma of the pancreas who were receiving best supportive care.

The decision was based on the offer of a Patient Access Scheme under which Pfizer provides the first cycle of Sutent free of charge, which lowered the cost per QALY (quality-adjusted life year) to £22,660.