New drugs for diabetes and infection control are among those given the green light for use in Scotland by the NHS.
The Scottish Medicines Consortium this week announced the latest group of treatments to be judged as cost-effective for use across Scotland’s 14 health boards.
These include dapagliflozin (Forxiga) for use in adults with type 2 diabetes. It is restricted to use as dual therapy in combination with metformin, when metformin alone with diet and exercise does not provide adequate glycaemic control and a sulphonylurea is inappropriate.
Dapagliflozin is the first in a new class of treatments called sodium-glucose cotransporter 2 inhibitors. It has been developed from phlorizin, a naturally occurring sugar compound found in the bark of apple trees, and works by reducing the amount of glucose reabsorbed in the kidney.
Another diabetes drug, vildagliptin (Galvus), was also accepted for restricted use within NHS Scotland.
It can be used as a monotherapy in adult patients inadequately controlled by diet and exercise alone and for whom metformin and sulphonylureas is inappropriate due to contraindications or intolerance.
In addition, a novel cephalosporin antibiotic for the treatment of complicated skin and soft tissue infections was approved by the SMC – again with restrictions.
Ceftaroline fosamil (Zinforo) can be used in patients with known or suspected MRSA infection. Specifically this includes
- Gram-positive only infections where vancomycin IV is inappropriate or has not been tolerated or treatment modification is required, and daptomycin IV or linezolid IV is normally used.
- Polymicrobial Gram-positive and common Gram-negative pathogens, where vancomycin IV in combination with gentamicin IV is inappropriate or has not been tolerated or treatment modification is required. And daptomycin IV in combination with gentamicin IV, or linezolid IV in combination with gentamicin IV, or tigecycline IV is normally used.
The SMC also approved budesonide gastro-resistant capsule (Budenofalk) for the symptomatic relief of chronic diarrhoea due to collagenous colitis, and glycopyrronium inhalation powder (Seebri Breezhaler) as a maintenance bronchodilator to relieve symptoms in adult patients with chronic obstructive pulmonary disease.