Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update - May 2011

The Scottish Medicines Consortium (SMC) has issued its monthly advice on new medicines.

Quetiapine prolonged release and immediate release (Seroquel XL® and Seroquel IR®) have been rejected for use in the treatment of major depressive episodes in bipolar disorder. The manufacturer did not present a sufficiently robust economic analysis to gain acceptance.

Tadalafil (Adcirca®) has been rejected for the treatment of pulmonary arterial hypertension. The manufacturer failed to make a submission.

Ticagrelor (Brilique®) has been accepted for use, when co-administered with aspirin, in the prevention of atherothrombotic events in adult patients with acute coronary syndromes. When administered with aspirin, ticagrelor demonstrated a significant reduction in ischaemic events compared with another antiplatelet drug without significantly increasing the incidence of study-defined major bleeding. However, the SMC notes that alternative treatments are available at a lower drug acquisition cost.

Tocofersolan oral solution (Vedrop®) has been rejected for the treatment of vitamin E deficiency due to digestive malabsorption in paediatric patients suffering from congenital chronic cholestasis or hereditary chronic cholestasis. The manufacturer did not supply any economic analysis therefore the cost-effectiveness could not be assessed.

Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.

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