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New antifungal micafungin among drugs accepted by SMC

Micafungin (Mycamine), a new antifungal agent (PJ, 16 August 2008, p186), has been accepted by the Scottish Medicines Consortium for use within NHS Scotland. The SMC is restricting micafungin use to the treatment of invasive candidiasis, as the manufacturer did not supply economic analyses for the medicine’s other licensed indications.

The monoclonal antibodies alemtuzumab (MabCampath) and rituximab (MabThera) have also been accepted by the SMC for restricted use throughout Scotland.

Alemtuzumab is accepted for the treatment of patients with B-cell chronic lymphocytic leukaemia (B-CLL) for whom fludarabine combination chemotherapy is not appropriate, with its use restricted to patients with previously untreated B-CLL with the 7-p deletion.

In an extension to December 2004 SMC advice (PJ, 15 January 2005, p40), rituximab is now accepted for use in combination with any chemotherapy regimen for previously untreated patients with stage III to IV follicular lymphoma. The drug is restricted to use by haematologists and oncologists with expertise in treating lymphoma, in a healthcare environment with full resuscitation facilities.

Pemetrexed (Alimta) has been accepted by the SMC as a monotherapy for the second-line treatment of patients with locally advanced or metastatic non-squamous non-small cell lung cancer. The acceptance follows a second resubmission of the treatment with improved economic data and new data showing a survival advantage for this group of patients when treated with pemetrexed.

Treatment with the drug is restricted to use in patients with good performance status who would otherwise be eligible for treatment with docetaxel.

The SMC has also approved ropinirole prolonged release tablets (Requip XL) for the treatment of idiopathic Parkinson’s disease in patients already taking ropinirole immediate release tablets and in whom adequate symptomatic control has been established.

The SMC rejected oral aripiprazole (Abilify) for the treatment of moderate to severe manic disorders in bipolar 1 disorder and for the prevention of new manic episodes in patients with predominantly manic episodes that have responded to aripiprazole treatment.

Citation: The Pharmaceutical Journal URI: 10030950

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