Three treatments have been approved for NHS funding in Scotland, bringing new options for gastroenteropancreatic tumours, lung and kidney cancers, but patients with multiple sclerosis will be unable to access Roche’s Ocrevus following a rejection by the SMC.

The SMC Committee has accepted Advanced Accelerator Applications’ radiopharmaceutical Lutathera (lutetium (177Lu) oxodotreotide) to treat gastroenteropancreatic tumours, a rare type of cancer that develops in the gut or pancreas.

Through the SMC’s Patient and Clinician Engagement (PACE) process for medicines used to treat very rare and end of life conditions, patients and clinicians highlighted the debilitating symptoms of the condition.

Lutathera offers “a considerable delay in progression of the disease, improved quality of life and an extended period of overall survival”, the cost watchdog concluded.

EUSA Pharma’s Fotivda (tivozanib) was accepted for the treatment of advanced renal cancer.

The drug is an oral, once-daily, potent selective vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI) that works by reducing the supply of blood to the tumour to deny it food and oxygen.

Again through PACE, patients and clinicians described a limited range of therapies currently available for advanced disease. Fotivda provides an additional initial treatment option, and has a different side effect profile “which may allow an improved quality of life for some patients,” the SMC said.

The committee also accepted Roche’s immunotherapy Tecentriq (atezolizumab) for the treatment of advanced non-small cell lung cancer (NSCLC), following consideration through the PACE process.

Tecentriq offers another treatment option for NSCLC “and has the advantage of requiring less frequent administration compared to some alternatives,” according to the SMC.

It is estimated 1,500 patients in Scotland will be eligible for treatment with the drug.

“We are delighted with the SMC’s decision, which means that people living in Scotland with this devastating form of lung cancer will now have access to the same treatment as patients living in other areas of the UK," said Simon Eayrs, integrated franchise lead at Roche Products.

“This decision demonstrates that all patients are able to get access to new and innovative treatments when parties work together to find a practical solution.”

On the downside, the committee rejected Roche’s Ocrevus (ocrelizumab) for the treatment of relapsing forms of multiple sclerosis, “because the evidence provided by the company about the cost effectiveness of the medicine when compared to other currently available treatments was not strong enough to justify accepting it for use by NHS Scotland”.

The drug has won backing from the National Institute for Health and Care Excellence in this setting, though it was recently turned down for primary progressive forms of MS in draft guidelines.