New £1,000 stroke drug sparks fears other patients may lose out

TENS of thousands of Scottish heart patients at risk of a stroke could benefit from a “life-saving” drug after the country’s medicines authority agreed to recommend the use of the treatment in the NHS.

However, the Scottish Medicines Consortium (SMC) ruling to allow medics to prescribe Pradaxa – the first blood-thinning drug to rival warfarin in 50 years – sparked fears of a possible sharp rise in costs to the cash-strapped health service.

Patients groups and cardiology specialists described the move as a “big step forward” for people with atrial fibrillation, a fast and irregular heartbeat that increases the risk of stroke.

The £2.52 a day cost of Pradaxa tablets – nearly £920 over 12 months, compared with £10 for a year’s supply of warfarin – led to a warning from Duncan McNeil, convener of Holyrood’s health committee, that the extra costs would be a “downside” despite the “overall good progress” the move would mean.

But Dr Alan Begg, a GP in Montrose with a special interest in cardiology, told The Scotsman Pradaxa would save the NHS money, as it would mean patients would suffer fewer side effects, such as bleeding, and would need fewer tests.

In yesterday’s ruling, the SMC said it found Pradaxa to be a “clinically and cost effective medicine for stroke prevention” and an alternative for patients not using warfarin because they could not tolerate the drug.

Although Scotland’s 14 health boards decide whether a drug will be prescribed in their area, a meeting of clinicians, managers and patients month will look at how Pradaxa can be made available to as many Scots as possible.

Dr Begg said the drug could gradually become available on the NHS for patients with atrial fibrillation – which affects an estimated 75,000 people in Scotland. He said: “This is a big step forward, as it doesn’t involve any monitoring of those taking Pradaxa.

“It wouldn’t have got approval if it hadn’t been cost-effective.”

Mr McNeil, a Labour MSP, welcomed the move but expressed concerns about NHS budgets.

He said: “The downside is that there could be an increase in overall costs to the NHS, but there’s also an upside, and that is that there would be overall good progress in treating people at risk of strokes.”

Scotland Patients Association chairwoman Margaret Watt said: “This could be a life-saver and it’s a super move that will mean so many patients have an alternative with this treatment.”

The Scottish Government said prescribing medicines was “a matter for NHS boards”.

A spokeswoman for Scotland’s biggest health board, NHS Greater Glasgow and Clyde, said the SMC move was “welcome”, while NHS Lothian promised to “review the advice” following yesterday’s ruling.