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Botox approved for the treatment of chronic migraine by Scottish NHS

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Botulinum toxin type A – better known as Botox – has been approved for use by the NHS in Scotland as a treatment for chronic migraine for some patients.

The Scottish Medicines Consortium announced today that Botox had been accepted for the treatment of chronic migraine in patients who experienced headaches on at least 15 days a month and who had been unsuccessfully treated with the other therapy options available.

The SMC noted that, as well as pain, chronic migraine patients may experience nausea, vomiting, diarrhoea, hypersensitivity to light, sound and smell, and visual disturbances, which together can “carry a significant impact on daily life”.



“There are currently limited treatment options for these patients and botulinum toxin type A (Botox) can help reduce the number of days in which they experience headache,” stated the SMC.

In its advice, the consortium highlighted that, in pooled analysis of two “pivotal” trials, Botox had significantly reduced the frequency of headache days compared with placebo.

SMC chair Professor Jonathan Fox said: “For those suffering with chronic migraine for which other treatments have not been effective, botulinum toxin type A (Botox) fulfils an unmet need.”

Another five new licensed medicines were also accepted today by the SMC for routine use by NHS Scotland.

  • Osimertinib (Tagrisso) was accepted for the treatment of non-small cell lung cancer
  • Everolimus (Afinitor) was accepted for the treatment of a rare type of tumour that develops in the lungs or intestine
  • Trifluridine/tipiracil (Lonsurf) was accepted for the treatment of advanced colorectal cancer in those patients who have already undergone several other treatments
  • Evolocumab (Repatha) was accepted for routine use to lower cholesterol levels in patients at high cardiovascular risk in whom standard drug therapy has not lowered cholesterol levels adequately
  • Iron (III) isomaltoside 1,000 (Diafer) was accepted for the treatment of iron deficiency in patients with chronic kidney disease who are on dialysis

However, the SMC said it was unable to approve desmospressin oral lyophilisate (Noqdima) for the treatment of idiopathic nocturnal polyuria.

Professor Fox said: “Unfortunately, the company’s evidence on the benefits of the medicine did not convince us that it would be a good use of NHS resources.”


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