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Komboglyze among medicines approved for use within NHS Scotland

A combination product for diabetes — saxagliptin plus metformin (Komboglyze) — is among the latest medicines accepted for use in NHS Scotland by the Scottish Medicines Consortium.

In advice published yesterday (13 January 2014), the SMC accepted saxagliptin plus metformin for adults with type 2 diabetes as part of triple therapy with a sulfonylurea. It says that in patients requiring triple therapy, using this combination product rather than three separate tablets “has the potential to reduce the pill burden at a lower cost”.

Tocilizumab (RoActemra) gained approval for the treatment of juvenile idiopathic polyarthritis in patients who have responded inadequately to methotrexate. It has previously been accepted by the SMC for other patient groups. Tocilizumab can be given in combination with methotrexate or as monotherapy if methotrexate is not tolerated or is inappropriate. This advice is dependent on a patient access scheme to improve the cost-effectiveness of tocilizumab.

Two medicines are accepted for restricted use. A subcutaneous form of trastuzumab (Herceptin) injection is accepted for adult patients with HER2 positive metastatic breast cancer or early breast cancer, but is restricted to those groups previously defined by the SMC for intravenous trastuzumab. The SMC notes that a study has shown that the subcutaneous formulation is as effective as the intravenous product and offers cost savings.

Also accepted for restricted use is bortezomib (Velcade) for the treatment of multiple myeloma. It is restricted to use as triple therapy in combination with dexamethasone and thalidomide.

Two medicines are not accepted for use because no submission was made by the licence holders: fentanyl citrate (Breakyl) for breakthrough pain in cancer and golimumab (Simponi) for ulcerative colitis.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11132818

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  • Velcade (bortezomib) (Dr P Marazzi/Science Photo Library)

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