dulaglutide (Trulicity)

following a full submission 

dulaglutide (Trulicity®) is accepted for restricted use within NHS Scotland.

Indication under review: in adults with type 2 diabetes mellitus to improve glycaemic control as add-on therapy in combination with other glucose-lowering medicinal products including insulin, when these, together with diet and exercise, do not provide adequate glycaemic control.

SMC restriction: as part of a triple therapy in patients with inadequate glycaemic control on two oral anti-diabetic drugs, as an alternative glucagon-like peptide 1 (GLP-1) agonist option.

Dulaglutide 1.5mg once weekly significantly reduced glycosylated haemoglobin (HbA1c) compared with a twice daily GLP-1 agonist and compared with a long-acting basal insulin analogue in patients with inadequate glycaemic control on two oral anti-diabetic drugs.

Dulaglutide is also indicated for adults with type 2 diabetes mellitus to improve glycaemic control as monotherapy when diet and exercise alone do not provide adequate glycaemic control in patients for whom the use of metformin is considered inappropriate due to intolerance or contraindications. SMC has not reviewed dulaglutide in this indication and cannot recommend its use within NHS Scotland.