The latest round of Scottish Medicines Consortium (SMC) decisions have brought medicines for breast cancer, skin cancer and schizophrenia into the spotlight and recommended them for use on the NHS in Scotland.
The governing body has firstly accepted Eli Lilly's Verzenios (abemaciclib) for the treatment of advanced or metastatic breast cancer in two different settings.
The drug was accepted for use in combination with aromatase inhibitors as an initial therapy in patients who have not had previous endocrine (hormone) based therapy, and works by prolonging the time breast cancer takes to progress and delays the need for chemotherapy.
It was also accepted for restricted use in combination with fulvestrant for patients whose condition has progressed on or after endocrine therapy or during first-line endocrine-based therapy.
MSD's Keytruda (pembrolizumab) was also accepted for advanced melanoma, following consideration through Post-acute care enablement (PACE), for use after surgery.
As there is no other active treatment available at this stage of the disease, the current management is just surveillance through routine monitoring and scans.
NHS funding was also agreed for Recordati's Reagila (cariprazine) for the second line treatment of schizophrenia in adult patients where the symptoms are diagnosed as being ‘predominantly negative’, including emotional withdrawal and inability to feel pleasure.
The decision provides another welcome treatment option for patients with these symptoms as existing anti-psychotic medicines can be limited in their effectiveness.
On the downside, Alliance Pharma's Xonvea (doxylamine succinate/pyridoxine hydrochloride) was rejected for the treatment of nausea and vomiting in pregnancy “as there was too much uncertainty in the company’s evidence about both its clinical benefits and its cost effectiveness”, said SMC chairman,Dr Alan MacDonald.
He continued, “Through the evidence given by patients and clinicians, we know that our decisions on abemaciclib will be welcomed, as this may allow patients to maintain a good quality of life for longer.’’
“Our decision on pembrolizumab means there is a treatment for patients currently relying on a ‘watch and wait’ approach to monitor their melanoma. Having the reassurance of a treatment that may give them more time will support those at this stage of the condition.”
“Cariprizine provides a helpful treatment option for those with schizophrenia whose main symptoms include lack of motivation and social withdrawal.”