April 2023 decisions news release

The Scottish Medicines Consortium (SMC), which advises on newly-licensed medicines for use by NHSScotland, has today (Monday 10 April) published advice on four medicines.

Trastuzumab deruxtecan (Enhertu®) was accepted for the treatment of metastatic HER2-positive breast cancer. It was considered through SMC’s Patient and Clinician Engagement (PACE) process, which is used for medicines for end of life and rare conditions. Trastuzumab deruxtecan is already available for use in NHSScotland in certain circumstances and this advice will mean patients can access it earlier in their treatment pathway.

Pembrolizumab (Keytruda) was accepted as a treatment for people with skin cancer who have had surgery. It was previously accepted by SMC for use in patients with more advanced disease and its use has now been extended to allow it to be given to people whose cancer is at an earlier stage.

Patiromer (Veltassa) was accepted for use in the emergency treatment of high potassium levels, alongside standard care.

The Committee was unable to accept darolutamide (Nubeqa®) for prostate cancer as there were uncertainties in the clinical and cost effectiveness evidence presented.

SMC chair, Scott Muir, said: “The data for trastuzumab deruxtecan is very promising and could allow patients to live for longer, without symptoms. The committee is aware of how highly valued this additional time is to patients and their families.

“We could not accept darolutamide as the evidence provided was not strong enough to satisfy the committee. The comparison with current treatments used in NHSScotland was associated with significant uncertainty that darolutamide would offer value for money.”