Scottish patients with diabetes have gained routine access to AstraZeneca/Britsol-Myers Squibb's Forxiga on the National Health Service after it was deemed cost-effective by regulators.

The Scottish Medicines Consortium has issued advice to healthcare professionals in the country endorsing the use of the first-in-class pill Forxiga (dapagliflozin) in adults with type 2 diabetes in combination with metformin, when metformin alone with diet and exercise does not provide adequate glycaemic control and use of a sulphonylurea is inappropriate.

Forxiga won European regulatory approval in November last year, becoming the first sodium-glucose cotransporter 2 (SGLT2) inhibitor to hit the market.

The drug has a unique mode of action that reduces the amount of glucose reabsorbed by the body, which means that it can be taken alongside other glucose-lowering therapies such as insulin to help boost glycaemic control.

Forxiga's green light in Europe was based on a comprehensive clinical trial programme involving 5,693 patients, which revealed that a significantly higher proportion of number of those taking the drug hit HbA1c targets compared to the control arm.

Weight-loss benefit

Crucially, the treatment was also linked with weight loss - sustained for two years - a particularly pertinent potential benefit given that many diabetics are also overweight; in Scotland 80% of patients with type 2 diabetes are overweight or obese.

Despite current treatments too many diabetes patients still fail to meet their blood glucose targets, which is critical to avoiding the serious consequences such as blindness, kidney failure and stroke, and so the availability of a new option to help control the disease will no doubt be welcome news for healthcare professionals and patients.

Around 200,000 people in Scotland currently have type 2 diabetes, and cases are on the rise, highlighting the urgent need for new therapies to help cushion the disease's effects.

Novartis' Seebri Breezhaler also in

Elsewhere, in good news for Novartis and Scottish patients with chronic obstructive pulmonary disease (COPD), the SMC has also endorsed the use of Seebri Breezhaler (glycopyrronium bromide) on the NHS.

The regulator is supporting the use of Seebri Breezhaler as a maintenance bronchodilator treatment to relieve symptoms in adult patients with COPD.

The decision is supported by data from the GLOW trials, which showed that the product is comparable to Boehringer Ingelheim's Spriva (tiotropium) for improving lung function, reducing shortness of breath and reducing exacerbations, and that, compared to placebo, it increases lung function from the first dose which is sustained for 24 hours.