July 2021 decisions news release

The Scottish Medicines Consortium (SMC), which advises on newly licensed medicines for use by NHSScotland, has today (Monday 12 July) published advice accepting three new medicines.

Atezolizumab (Tecentriq) was accepted for the treatment of adult patients with advanced hepatocellular carcinoma (HCC, a type of liver cancer), who have not received prior therapy. Atezolizumab was considered through SMC’s Patient and Clinician Engagement (PACE) process, which is used for medicines for end of life and rare conditions. PACE participants spoke of the devastating impact HCC has on patients, including fatigue, pain, and ascites (an abnormal build-up of fluid in the abdomen which can make it difficult to eat and breathe). There is currently no cure. Atezolizumab is used in combination with another medicine, bevacizumab. This combination treatment may be better tolerated by patients than the currently available treatments, allowing patients to maintain their quality of life and remain independent for longer. Patients who respond to atezolizumab may also live longer than those receiving current treatments.

Ofatumumab (Kesimpta) was accepted for the treatment of relapsing-remitting multiple sclerosis (RRMS), in patients with active disease (when patients have relapses or signs of active inflammation on scans). Ofatumumab offers another treatment option for patients and has the potential to reduce relapse rates, slow disease progression and improve quality of life. Offered as a monthly self-injection, this treatment option may minimise the treatment burden for many people with relapsing-remitting MS and reduces the need for regular hospital visits.

Bempedoic acid (Nilemdo) was accepted for use in some patients with high levels of fats in the blood, including cholesterol. It is used in patients who have primary hypercholesterolaemia or mixed dyslipidaemia. The orally administered tablet is used in combination with ezetimibe, another cholesterol lowering medicine. This provides a treatment option when ezetimibe alone doesn’t lower cholesterol adequately and no other treatments are available.

The committee was unable to accept tafamidis (Vyndaqel) for use in patients with transthyretin amyloidosis (a rare condition in which fibres called amyloid build up in tissues around the heart). Tafamidis was not recommended as the evidence provided by the company was not strong enough to satisfy the committee that it offers value for money to NHSScotland.

SMC chairman Mark MacGregor said:

“I am pleased the committee has been able to accept these three medicines for use by NHSScotland.”

“Participants in our PACE meeting for atezolizumab told us of the devastating impact of hepatocellular carcinoma (HCC), a type of liver cancer, on patients and their family. We know availability of this medicine will be welcomed and we hope it may allow patients to enjoy a better quality of life.”

“Ofatumumab offers patients with relapsing-remitting MS, another treatment option with the benefit of a monthly self-injection.”

“Our decision on bempedoic acid provides a treatment option for certain patients with high cholesterol when no other treatments are available.”

“We were unable to accept tafamidis as the evidence provided by the company was not strong enough to satisfy the committee of its cost effectiveness.”

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