New emergency contraceptive amongst latest drugs approved for use on Scottish NHS

The Scottish Medicines Consortium (SMC) has accepted the following drugs for use within NHS Scotland:

  • Ustekinumab (Stelara) for adults with moderate to severe plaque psoriasis who failed to respond to, are intolerant of, or have a contraindication to standard systemic therapies including ciclosporin, methotrexate and PUVA.
  • Trospium chloride (Flotros) for urge incontinence, increased urinary frequency and urgency in patients with overactive bladder.
  • Calcium acetate (PhosLo) for the prevention and treatment of hyperphosphataemia in patients with advanced renal failure on dialysis.
  • Sildenafil (Revatio) to improve exercise capacity in patients with pulmonary arterial hypertension WHO functional class II. Treatment must be initiated by a specialist.
  • Ulipristal (Ellaone) for emergency contraception within 120 hours (5 days) of unprotected sexual intercourse or contraceptive failure.
  • Somatropin (Omnitrope) for children with growth disturbance due to growth hormone deficiency, Turner syndrome or chronic renal insufficiency; children with Prader-Willi syndrome; and for growth disturbance in short children born small for gestational age. It is also endorsed for replacement therapy in adults with pronounced growth hormone deficiency.
  • Epoetin alfa (Binocrit) for anaemia associated with chronic renal failure in adults and children on haemodialysis and adults on peritoneal dialysis; and for severe symptomatic renal anaemia in adults with renal insufficiency not yet on dialysis. Binocrit can also be used to increase the yield of autologous blood before donation in individuals who meet specific criteria.
  • Pemetrexed (Alimta), in combination with cisplatin, for the first-line treatment of locally advanced or metastatic non-small cell lung cancer other than predominantly squamous cell histology.
  • Cetuximab (Erbitux), in combination with chemotherapy, for EGFR-expressing, KRAS wild-type metastatic colorectal cancer. It is approved for patients who have not previously received chemotherapy for their metastatic disease and who have liver metastases only that are considered non-resectable but which could become curatively resectable after treatment.

Two antiretroviral drugs have received SMC endorsement for extended indications:

  • Darunavir (Prezista) and tipranavir (Aptivus), co-administered with low-dose ritonavir, in combination antiretroviral treatment of HIV-1 infection in:

– highly pre-treated children aged from 6 years and weighing at least 20kg, who have failed on more than one regimen containing a protease inhibitor (darunavir)
–  highly pre-treated children from 12 years of age with virus resistant to multiple protease inhibitors (tipranavir 250mg soft capsules)
– highly pre-treated children from 2 to 12 years of age with virus resistant to multiple protease inhibitors (tipranavir 100mg/ml oral solution)

Finally, aliskiren (Rasilez) was rejected by the SMC for the treatment of essential hypertension, on the grounds that its application failed to present an adequate clinical or economic analysis.

Further information: SMC

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