February 2026 decisions news release

The Scottish Medicines Consortium (SMC), which advises on newly licensed medicines for use by NHSScotland, has today (Monday, February 09) published advice on three medicines.

Donanemab (Kisunla®) was not recommended to treat the early stages of Alzheimer’s disease in adults who carry one or no copies of a gene called ApoE4.

Sotatercept (Winrevair®) was not recommended used together with other medicines in adults with pulmonary arterial hypertension (PAH) to improve exercise capacity. PAH is a condition that causes abnormally high blood pressure in the arteries of the lungs.

Zuranolone (Zurzuvae®) was not recommended for the treatment of moderate or severe postnatal depression in adults following childbirth.

SMC Chair Dr Scott Muir said:

“SMC welcomed the resubmission for donanemab and recognises the need for new therapies for Alzheimer’s disease. However, having considered all the evidence, the committee was still unable to accept donanemab for use in the NHS in Scotland. They felt that there remains uncertainty around what the modest clinical benefit means for patients and their families, and, in addition, the company’s evidence around its cost effectiveness was not sufficient.

“The committee was also unable to accept sotatercept for the treatment of adults with PAH. The company’s evidence around the cost effectiveness of the treatment compared to currently available options was not sufficient.

“The committee was also unable to accept zuranolone for the treatment of adults with postnatal depression as the company’s evidence around the cost effectiveness of the treatment compared to currently available options was not sufficient.

“We were disappointed that we were unable to accept any of these medicines, however it is SMC’s responsibility to ensure that only medicines that are clinically and cost effective are accepted for routine use in the NHS In Scotland. We would welcome resubmissions from the companies addressing the issues we have raised.”