hydrocortisone (Plenadren)

following a full submission considered under the orphan process:

hydrocortisone modified release (Plenadren®) is not recommended for use within NHS Scotland.

Indication under review: Treatment of adrenal insufficiency in adults. 

Compared with three times daily immediate-release hydrocortisone, once daily modified-release hydrocortisone (taken in the morning) demonstrated approximately 20% lower cortisol exposure over 24 hours. A high cortisol concentration peak in the morning and gradual decline during the afternoon with modified-release hydrocortisone partially reflects the physiological profile. 

The submitting company did not present a sufficiently robust clinical and economic analysis to gain acceptance by SMC.

This advice takes account of the views from a Patient and Clinician Engagement (PACE) meeting.