A cannabis-based medicine for multiple sclerosis patients has been accepted for use on the NHS in Scotland.
Drugs for cancer patients and adult kidney transplant patients are also among those for which the Scottish Medicines Consortium (SMC) issued advice in its latest round of decisions.
Delta-9-tetrahydrocannabinol and cannabidiol, known as Sativex, has been accepted as a treatment to improve symptoms in some adults with muscle stiffness and spasms due to multiple sclerosis (MS).
The committee heard from MS patient groups about the debilitating effect that muscle spasms can have on their day-to-day lives, impairing mobility, increasing the risk of falls, affecting their ability to look after themselves and aggravating fatigue and depression.
Sativex is an oral spray treatment taken in combination with a patient’s current treatment.
Mark MacGregor, SMC chairman, said: “I am pleased we were able to accept these medicines for use by NHS Scotland.
“We heard powerful testimony from MS groups of the devastating effects of spasticity on patients with multiple sclerosis.
“Delta-9-tetrahydrocannabinol and cannabidiol will provide a treatment option to improve quality of life for patients, where other treatments are not working well enough.”
Morna Simpkins, director of MS Society Scotland, welcomed the decision.
She said: “MS is relentless, painful and disabling. Sativex has been proven to relieve muscle spasms and their associated pain, leading to increased mobility, better sleep patterns and improved quality of life for the person living with MS and their family and loved ones.
“We will continue to work with the SMC, NHS Scotland, individual health boards and neurologists to ensure Sativex quickly becomes available to everyone throughout Scotland whose life could be significantly improved by taking it.”
The SMC has also accepted Nivolumab given in combination with chemotherapy as a treatment for some adults with gastro-oesophageal junction cancer – the area where the food pipe joins the stomach.
It said the addition of nivolumab to chemotherapy may increase survival, allowing patients to spend more time with family and loved ones.
Apalutamide has been accepted as a treatment for some patients with prostate cancer that has spread to other parts of the body.
Given in combination with androgen deprivation therapy, it provides an additional oral treatment option that can slow disease progression and increase survival.
The committee also accepted imlifidase, a treatment for highly sensitised adult kidney transplant patients to improve their chances of avoiding organ rejection after a transplant.
MacGregor added: “Nivolumab may increase survival in patients with advanced gastro-oesophageal cancer and we know that even small extensions in the duration of life are of considerable importance to patients and families.
“A metastatic prostate cancer diagnosis brings a heavy burden on patients, and symptoms get worse as the disease progresses. Apalutamide will offer another useful alternative oral treatment in helping to slow disease progression and extend life.”
Tofacitinib was accepted for the treatment of adults with ankylosing spondylitis (AS), a chronic inflammatory rheumatic disease that affects the spine and pelvis.
Meanwhile, an initial assessment report has been published for velmanase alfa, a treatment for a rare genetic condition called alpha-mannosidosis which is caused by a faulty gene.
Children who develop the disease can suffer a range of issues including skeletal abnormalities, recurrent infections and muscle weakness.
Velmanase alfa has been assessed through the ultra-orphan pathway for medicines aimed at extremely rare conditions.
It will be available for three years while further information is gathered.
Following this, SMC will review the evidence and make a decision on routine availability in NHS Scotland.
The committee said it was unable to accept zanubrutinib for the treatment of Waldenstrom’s macroglobulinemia, a rare type of blood cancer, as there was uncertainty around its cost-effectiveness.
The SMC said the evidence provided by the company was not strong enough to satisfy the committee that it offers value for money to NHS Scotland.
