SMC guidance on AstraZeneca's diabetes drug and Roche's MabThera

The Scottish Medicines Consortium (SMC) has issued guidance on Anglo-Swedish drug major AstraZeneca’s (LSE: AZN) Forxiga (dapagliflozin), a first-in-class sodium-glucose co-transporter 2 (SGLT2) inhibitor for type 2 diabetes. It has also approved a new subcutaneous injection form of Swiss drug major Roche’s (ROG: SIX) MabThera (rituximab) in the treatment of non-Hodgkin’s lymphoma, which will replace the current intravenous infusion.

The guidance stated that Forxiga is now accepted for restricted use within NHS Scotland as part of a triple therapy in combination with metformin and sulphonylurea, as an alternative to dipeptidyl peptidase-4 (DPP-4) inhibitors. Triple therapy can be prescribed to improve glycemic control with metformin and sulphonylurea, when these, together with diet and exercise, do not provide adequate blood glucose control. The appropriate patients in Scotland on metformin and sulphonylurea can now also be prescribed dapagliflozin to improve glycaemic control. In addition, unlike other classes of oral diabetes medicines, including DPP-4 inhibitors, SGLT2 inhibitors like dapagliflozin also offer an additional benefit of weight loss, which is particularly important as 80-85% of people with type 2 diabetes are overweight, increasing their risk of developing cardiovascular complications.

Lisa Anson, president, AstraZeneca UK and Ireland, said: “Over 66,000 prescriptions have been written for dapagliflozin since it was launched in the UK last year and this latest decision by the SMC means that more patients will be able to access it through NHS Scotland. Dapagliflozin is the only SGLT2 inhibitor that has this level of real-world patient experience in the UK, as well as clinical data showing significant reductions in blood sugar, weight and rates of hypoglycaemia over four years.”