The Scottish Medicines Consortium (SMC) has issued its monthly advice on newly licensed medicines.
Rimegepant (Vydura®) has been rejected for use as a preventive treatment of episodic migraine in adults who have at least four migraine attacks per month. The justification of the cost in relation to its health benefits was not sufficient and the submitting company did not present a sufficiently robust clinical and economic analysis to gain acceptance by SMC.
Rimegepant (Vydura®) has been accepted for restricted use for the acute treatment of migraine with or without aura in adults. The restrictions limits use to patients who have had inadequate symptom relief after trials of at least two triptans or in whom triptans are contraindicated or not tolerated; and have inadequate pain relief with non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol.
Empagliflozin (Jardiance®) has been accepted for use in adults for the treatment of symptomatic chronic heart failure with preserved ejection fraction (left ventricular ejection fraction [LVEF] >40%).
Icosapent ethyl (Vazkepa®) has been rejected for use to reduce the risk of cardiovascular events in adult statin-treated patients at high cardiovascular risk. The submission reviewed potential use in patients with elevated triglycerides (≥1.7mmol/L) and established cardiovascular disease or diabetes plus at least one other risk factor. The submitting company did not present a sufficiently robust clinical and economic analysis to gain acceptance by SMC.
Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.