SMC accepts four medicines for NHS use

Roche’s Perjeta, a medicine used to treat early stage breast cancer, has been accepted by the Scottish Medicines Consortium (SMC) for use on the NHS in Scotland.

The drug, which is used in combination with Herceptin (trastuzumab) and chemotherapy to treat a particular type of early stage breast cancer prior to surgery, was accepted following consideration through SMC’s Patient and Clinician Engagement (PACE) process, for medicines used at the end of life and for very rare conditions.

Perjeta (pertuzumab) has US and EU approval after data showed that it nearly doubled the number of women whose tumours were eradicated compared with current treatment, and that patients were 40% more likely to be disease-free after three years.

An estimated 415 patients per year in Scotland could be eligible to receive Perjeta in the neoadjuvant setting.

"We often treat patients with HER2-positive early breast cancer with a course of chemotherapy and trastuzumab to shrink their cancer before they have surgery. By adding Perjeta, we increase the chances of eliminating the cancer in the breast and we know that this is associated with good long-term outcomes," said Dr Iain Macpherson, consultant medical oncologist at The Beatson Cancer Centre in Glasgow. "This is a positive development for patients with breast cancer in Scotland."

The SMC also approved NHS funding for Bristol-Myers Squibb’s Opdivo (nivolumab) for advanced melanoma, Roche’s Ocrevus (ocrelizumab) for treatment of relapsing remitting multiple sclerosis (MS), and Santen’s Verkazia (ciclosporin) eye drops for severe vernal keratoconjunctivitis in children and teenagers.

According to Roche, the recommendation of Ocrevus for MS is "a major milestone" for Scotland, where incidence of the condition remains the highest in the UK, with over 11,000 people living with the condition, and Orkney having recorded the world’s highest rate. The drug has been shown to reduce the number of relapses per year by nearly half, and slow the risk of progression of the disease when compared with current treatment.

‘This is really welcome news for people with relapsing MS in Scotland, as it gives them access to proven treatment alongside people in the rest of the UK," said Linden Muirhead, director, Information and Engagement at the MS Trust.

Further, the approval of Opdivo marks a change in the treatment in Scotland of melanoma for patients eligible for surgery, who are currently only monitored to see if their cancer returns, known as the "watch and wait" approach, at which point the cancer has often already progressed.

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