The Scottish Medicines Consortium (SMC) has accepted the following drugs for use in NHS Scotland:
- Sitagliptin 50mg and metformin 1000mg (Janumet 50/1000) is restricted to use in patients for whom a combination of sitagliptin and metformin is an appropriate choice of therapy and only when the addition of sulfonylureas to metformin monotherapy is not appropriate. Sitagliptin represents an alternative to other agents such as thiazolidinediones (glitazones).
- Lenalidomide (Revlimid) in combination with dexamethasone, for the treatment of multiple myelomas, is restricted to use in patients who have received at least 2 prior lines of therapy.
- Nicotinic acid/laropiprant (Tredaptive) is restricted to use as monotherapy for the treatment of dyslipidaemia in patients with combined mixed dyslipidaemia (characterised by elevated levels of LDL-cholesterol and triglycerides and low HDL-cholesterol) in patients in whom statins are considered inappropriate or not tolerated.
- Raltegravir (Isentress) is restricted to use in patients who are intolerant of or resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs) or protease inhibitors (PIs) or when these options are compromised owing to drug-drug interactions.
In the absence of a submission to the SMC the following drugs cannot be recommended for use in NHS Scotland:
- Telmisartan (Micardis) for cardiovascular prevention or type II diabetes mellitus with documented target organ damage.
- Abatacept (Orencia) for juvenile idiopathic arthritis.
Finally, gefitinib (Iressa) was rejected following a full submission for the treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with activating mutations of epidermal growth factor receptor tyrosine kinase (EGFR-TK).
Further information: SMC