antibioticsThe Scottish Medicines Consortium (SMC) has published advice accepting three new medicines for frontline use by NHS Scotland.

The new drugs are eribulin (Halaven) for advanced breast cancer, sacubitril/valsartan (Entresto) for chronic heart failure and enzalutamide (Xtandi) for prostate cancer. However, the SMC was unable to accept nivolumab (Opdivo) for melanoma (skin cancer) and pertuzumab (Perjeta) for treatment of early stage breast cancer in patients before they receive surgery.

Eribulin was accepted for the treatment of advanced breast cancer in those patients who have already received a number of treatments. It was considered under the SMC’s PACE (Patient and Clinician Engagement) process, during which patient groups and clinicians highlighted that eribulin may give patients two to three months additional survival, which is extremely valuable in the context of limited remaining months.

Sacubitril/valsartan was accepted for the treatment of chronic heart failure. A patient group submission from Chest, Heart and Stroke Scotland stated that sacubitril/valsartan has the potential to prevent early death and also reduce hospital admissions. Sacubitril/valsartan offers a further treatment option for patients suffering from this condition.

Enzalutamide (Xtandi) was also accepted following consideration by an Independent Review Panel convened by SMC. SMC has previously accepted enzalutamide for use in patients who have already received chemotherapy. This submission related to the medicine’s use at an early stage in the treatment pathway for prostate cancer before chemotherapy. Enzalutamide offers this patient group a significant improvement in survival and quality of life and provides a further treatment option in the pre-chemotherapy setting.

Professor Jonathan Fox, Chairman of SMC, said: “I am pleased we were able to accept these new medicines for routine use in NHS Scotland. We know from the powerful inputs we received from patient groups that our advice on medicines for advanced breast cancer, chronic heart failure and prostate cancer will be welcomed.

“Unfortunately, the Committee was not able to recommend pertuzumab for early stage breast cancer in the pre-surgery setting or nivolumab for advanced melanoma. Uncertainties in the evidence for both these medicines meant the Committee was concerned they may not represent a good use of NHS resources. We appreciate these decisions will be disappointing for patients and would welcome resubmissions addressing the points raised.”