Welsh body rules on use of new medicines

The All Wales Medicines Strategy Group (AWMSG) has published its judgements on the use of six new drugs within NHS Wales. Recommendations issued by this organisation should be followed by Welsh prescribers until any decisions are made by NICE.

The following medicines were rejected for use within NHS Wales:

  • Micafungin (Mycamine) for the treatment of invasive candidiasis in adults and children. AWMSG believes the drug's cost-effectiveness is unproven.
  • Prolonged-release tacrolimus (Advagraf) for the prophylaxis of transplant rejection in adult kidney or liver allograft recipients and the treatment of treatment-resistant allograft rejection in adults. Cost-effectiveness data for the product were insufficient to support its endorsement. However, healthcare professionals should continue to prescribe Advagraf in patients already taking the drug.
  • Aliskiren (Rasilez) for the treatment of essential hypertension. Clinical and cost-effectiveness data for the product were insufficient to support its endorsement.

Three medicines have been approved.

  • Bivalirudin (Angiox) is recommended for the treatment of adult patients with acute coronary syndromes scheduled for urgent or early intervention. Bivalirudin must be given with aspirin and clopidogrel and should only be considered in situations where both a glycoprotein IIb/IIIa inhibitor and heparin would otherwise be used. AWMSG envisages that bivalirudin will mainly be used when there is a high risk of bleeding.
  • Aripiprazole (Abilify) is endorsed for the treatment of moderate to severe manic episodes in bipolar I disorder and for the prevention of manic episodes in patients who experience predominantly manic episodes, which respond to aripiprazole.
  • Intravenous topotecan (Hycamtin) is recommended for use with cisplatin to treat recurrence of cervical carcinoma after radiotherapy and for stage IVB disease. Use of the drug in cisplatin-naïve patients is restricted.
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