Raltegravir approved inScotland
On 10 May 2010, the Scottish Medicines Consortium (SMC) announced that raltegravir (Isentress) had been accepted for restricted use within NHS Scotland for using in combination for adult patients.
The indication included not only in the context of drug resistance to other classes, but for patients where drug interactions to other medications is problematic, and most important for patients who are intolerant to protease inhibitors and NNRTIs due to difficult side effects.
Despite the delay in this decision (raltegravir was approved in Europe in January 2008) patients in Scotland have been able to access the drug if it was needed to treat multidrug resistant virus.
The indication for tolerability is important, as this option that could improve quality of life for many patients is unlikely to be available in England, and certainly not in London, while the price differential remains so significantly compared to every other antiretroviral (apart from tipranavir and T-20, both of which are rarely used).
Source: MSD press release. Scottish Medicines Consortium approves expanded use of first-in-class integrase inhibitor, Isentress (raltegravir), for the treatment of HIV in appropriate patients. (10 May 2010). http://www.pharmiweb.com/pressreleases/pressrel.asp?ROW_ID=21506