Nycomed's cancer pain drug Instanyl cleared for NHS use in Scotland

Switzerland-headquartered Nycomed says it welcomes the decision by the Scottish Medicines Consortium (SMC) on Instanyl, (intranasal fentanyl), the only fast-acting intranasal treatment licensed for breakthrough cancer pain. The SMC decision means that cancer patients in Scotland will now have another option for the treatment of breakthrough cancer pain within the National Health Service in Scotland, the privately-owned drugmaker notes.

In its submission to the SMC, Nycomed estimated a net drug budget impact of £11,000 ($18,260) in year one, rising to £418,000 in year five. These figures assume some displacement of oral morphine and other fentanyl preparations, the agency noted. Given the niche position proposed, the budget impact should be less than estimated by the manufacturer as there would be no displacement of oral morphine. The manufacturer estimated eight patients would be eligible in year one rising to 309 in year five.

Breakthrough cancer pain is a severe or excruciating pain of sudden onset and short duration that bursts through the background 'round the clock' pain medication making management difficult. Breakthrough cancer pain, which affects up to 95% of patients with chronic cancer pain, is typically severe, sudden and brief, lasting an average of 30 minutes and striking on average four times a day.

Instanyl received a European Union license in July 2009 for the treatment of breakthrough pain in adult patients already receiving maintenance opioid therapy for chronic cancer pain.