Streamlining SMC processes for medicines that clearly offer good value to NHSScotland

Following a positive stakeholder evaluation, a change to SMC process for medicines introduced on an interim basis during the COVID-19 pandemic, is now permanent.

The SMC new medicine assessment process involves evaluation by two committees:

• Firstly, the New Drugs Committee (NDC) assesses the clinical and economic evidence presented by the company, supplemented by clinical expert comment. This preliminary NDC advice is provided to the submitting company, allowing them to provide feedback to address any uncertainties before the medicine is considered by the SMC committee.
• The review at SMC committee takes a broader perspective, including input from Patient and Clinician Engagement (PACE) meetings and/or patient group partners.

In approximately 20% of submissions, NDC considers that the clinical and economic case is strong and the advice to SMC is to accept the medicine for use. Since July 2020, SMC has issued advice on these medicines following SMC executive review; consideration at SMC committee has not been required. The aim of this process change was to reduce demand on SMC committee slots and the associated workload for SMC committee members, staff, patient groups and submitting companies.

The evaluation found it was considered a pragmatic approach that has allowed SMC to streamline the review of new medicines in Scotland. The process has also allowed SMC, patient group partners and pharmaceutical companies to make efficient use of resources. The evaluation also found that this process has helped to create capacity for SMC committee members.

Participants in the evaluation did not report any major concerns about the process. Some suggestions for improvement included integration into SMC business-as-usual and further consideration of input from Patient Group Partners. SMC’s Public Involvement Network (PIN) Advisory Group is taking this forward.