MBC Scotland

Scotland is the one part of the UK where the decision about whether the NHS will pay for a cancer drug is not made by NICE. It is made by the Scottish Medicines Consortium, which appraises medicines independently.

That is not a technicality. It is the reason a woman in Glasgow and a woman in Manchester with the same diagnosis, the same test results and the same oncologist's recommendation can get different answers about the same drug in the same month.

What the SMC has decided

We have followed these decisions as they were made, and written about each one at the time.

Tucatinib — accepted for routine use in NHS Scotland in January 2022. NICE approved it for England and Wales the following month, and we wrote then that England and Wales were "joining Scotland". Scotland was first. The SMC decision · The NICE decision
Trodelvy — approved by the SMC in March 2022 for metastatic triple negative breast cancer. Our post
Pembrolizumab — approved in October 2022. Our post
Enhertu (trastuzumab deruxtecan) — accepted for routine use in April 2023. Our post

And the one that went the other way:

Piqray (alpelisib) — denied by the SMC in January 2023. Our post

A separate process is not automatically a worse one. Scotland has been ahead of England more than once. But it does mean that where you live changes what you can be given, and that is what we campaign against.

If you are in Scotland

If a treatment your team wants to give you is not funded here, we want to know. Individual refusals are how we build the case that the system is not working, and we have used them in evidence before.

We are also looking for members in Scotland who are willing to speak to the press, respond to SMC consultations, or simply be in touch with other people living with this here.

Email metupuk@gmail.com, or join us.

More on how drug decisions are made across the UK: Improving access to new breast cancer drugs · Research and access to drugs