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Two more diabetes drugs approved for use by NHS in Scotland

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Two medicines for treating diabetes, along with one for advanced breast cancer, have been approved for use by the NHS in Scotland.

Ertugliflozin (Steglatro) and semaglutide (Ozempic) have both been accepted for “restricted use” in the health service by the Scottish Medicines Consortium.

“Ertugliflozin and semaglutide provide other helpful treatment options”

Alan MacDonald

In addition, pertuzumab (Perjeta) can now be used for the treatment of HER2 positive metastatic breast cancer or locally recurrent unresectable breast cancer, said the SMC today.

Ertugliflozin, made by Merck Sharp & Dohme, has been accepted for the treatment of type 2 diabetes as part of a package of treatment which includes diet and exercise to improve glycaemic control, according to the consortium’s latest guidance.

Semaglutide was also accepted for the treatment of type 2 diabetes alongside a diet and exercise regime, said the SMC in its new guidance on the Novo Nordisk drug.

SMC chair Dr Alan MacDonald said: “Ertugliflozin and semaglutide provide other helpful treatment options for those with diabetes mellitus.”

The body added that the drug pertuzumab could now be used for treating HER2 positive breast cancer that had spread or that had come back locally after treatment and could not be removed by surgery.

“This is a fatal and aggressive sub-type of breast cancer, and the outlook at this stage of the disease is very poor,” noted the consortium.

“We know from the testimonies given through our PACE process how devastating this condition is”

Alan MacDonald

In such cases, pertuzumab could be used in combination with other cancer drugs like trastuzumab and docetaxel, according to the guidance from the consortium.

The SMC noted that the drug was accepted following consideration through its patient and clinician engagement (PACE) process for medicines used at the end of life and for very rare conditions.

Patient groups and clinicians “spoke of this type of breast cancer commonly affecting younger women at a stage in their lives where they often have responsibility for young families, have significant work commitments or may be carers for elderly parents”, it highlighted.

“Pertuzumab improves overall survival, offering women improved quality of life and valuable extra time with their families,” stated the SMC.

Dr MacDonald said: “We are pleased to be able to accept pertuzumab for the treatment of HER2 positive metastatic breast cancer or locally recurrent unresectable breast cancer.

“We know from the testimonies given through our PACE process how devastating this condition is for patients and their families,” he said. “We hope this decision, which offers the opportunity of extra time when the patient feels well, will be welcomed by them.”

The drug was made available to breast cancer patients in England in November 2017, after NHS England and its manufacturer Roche reached a commercial agreement. The National Institute for Health and Care Excellence had previously deemed pertuzumab as being too expensive.

“The evidence provided by the company was not strong enough”

Alan MacDonald

Meanwhile, tofacitinib (Xeljanz) was also accepted by the SMC for the treatment of psoriatic arthritis. The approval offered another option for patients who have not responded to previous therapies, it noted.

However, arsenic trioxide for the treatment of acute promyelocytic leukaemia, a very unusual form of leukaemia, was not recommended.

The SMC committee said it was unable to accept arsenic trioxide as there was “too much uncertainty” in the evidence submitted by the company about the benefits the medicine may bring.

Dr MacDonald said: “The committee was unable to accept arsenic trioxide for acute promyelocytic leukaemia as the evidence provided by the company was not strong enough.”

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