Three New Drugs Green-Lighted for NHS Scotland
Cost regulators for the NHS in Scotland have endorsed new medicines for the treatment of HIV, asthma and MRSA-related skin infections.
The SMC (Scottish Medicines Consortium) put forward Janssen-Cilag’s Rezolsta (darunavir cobicistat) in combination with another antiretroviral as an option for the treatment of HIV-1 infection in adults aged 18 years or older.
Rezolsta combines the company’s profitable HIV therapy Prezista (darunavir) and Gilead’s Tybost (cobicistat), the combination offers an alternative for patients who cannot tolerate the side effects of other treatments in a single pill, making it easier to manage and monitor treatment regimes.
Janssen forecast the gross medicines budget impact to be £286,000 in year one and £1 million in year five. However as other medicines were assumed to be displaced, the net medicines budget impact was estimated to be cost neutral.
The SMC also accepted Boehringer Ingelheim’s Spiriva Respimat (tiotropium) for the treatment of asthma. The drug is already used for chronic obstructive pulmonary disease and is now the first medicine in this class to be licensed for use in combination with other treatments in patients with severe, persistent, poorly controlled asthma, in order to boost lung function and reduce the risk of severe asthma attacks.
The gross and net impact on the medicines budget is estimated to be £301,000 in year one and £4.3 million in year five.
Whilst MSD’s once-daily antibiotic Sivextro (tedizolid phosphate) has been endorsed as a cost-effective option for the treatment acute bacterial skin infections and infections of the structures beneath the skin, including conditions such as cellulitis, skin abscesses and wound infections.
But use of the drug has been restricted so that it should only be considered as an alternative oxazolidinone antibacterial on the specific advice of local microbiologists or specialists in infectious disease.
MSD estimates that around 40 patients will be eligible for treatment each year with an estimated uptake rate of 5% in year one and 45% in year five, and that the gross medicines budget impact will be £2,000 and £16,000, respectively.
Despite these approvals the SMC said it was unable to recommend Eisai’s Halaven (eribulin) for breast cancer or Astellas’ Xtandi (enzalutamide) for castration-resistant prostate cancer, as the cost was too high in relation to their benefit.