What has SMC said?

The Scottish Medicines Consortium (SMC) has not recommended sotatercept used together with other treatments in adults with pulmonary arterial hypertension (PAH) to help improve exercise capacity. PAH is a condition that causes high blood pressure in the arteries of the lungs leading to breathlessness and fatigue. Sotatercept is used with other PAH medicines to treat adults who have a moderate or marked limitation in their physical activity.

This document summarises the SMC decision and what it means for patients.

You can find more detailed information about the SMC assessment of sotatercept by looking at the SMC Detailed Advice Document (SMC2831).

What does SMC’s decision mean for patients?

Sotatercept for use as described above should not normally be prescribed on the NHS in Scotland. Your healthcare professional should talk with you about other treatment options.

If your healthcare professional thinks you would benefit from it, they can make a request to prescribe sotatercept. All health boards have procedures in place to consider these requests.

You can find more information about making decisions about your treatment here: Medicines in Scotland: What’s the right treatment for me?

More about SMC’s decision

SMC was unable to accept sotatercept as described above for routine use. The company's evidence of the medicine’s value for money was not strong enough.

How does SMC make its decision?

SMC carefully considers every new medicine to make sure it benefits patients and is likely to be a good use of NHS resources.

To do this SMC studies the following:

  • Evidence from the company about how well the medicine works compared with current treatments available in Scotland, in relation to how much they will cost to buy and use to treat patients.
  • Information from patient groups about the potential impact of the medicine on patients and carers.
  • Advice from healthcare professionals about any benefits of the new medicine compared to current treatment, along with how the new medicine is likely to be used.

When SMC assesses a medicine it takes account of the needs of all patients in NHSScotland, not only those who may be treated with the medicine.

You can find out more about how SMC decides here: https://www.scottishmedicines.org.uk/how-we-decide/

More information and support

The organisation below can provide more information and support for people living with PAH and their families. SMC is not responsible for the content of any information provided by external organisations.

Pulmonary Arterial Hypertension Association UK
https://www.phauk.org

You can find out more about sotatercept (brand name: Winrevair®) in the Patient Information Leaflet (PIL) by searching for the medicine name on the Medicines and Healthcare products Regulatory Agency (MHRA) website.
https://products.mhra.gov.uk/

Date advice published: 09 February 2026
SMC ID: SMC2831