Following consideration of a resubmission, the Scottish Medicines Consortium (SMC) does not recommend the use of aprepitant (Emend®) within NHS Scotland as part of combination therapy, for prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy.

The Drug Advice (available at the link below) notes that compared to a comparator antiemetic regimen, aprepitant has been shown to increase the proportion of patients achieving a complete response in a study of breast cancer patients or experiencing no vomiting in patients with a range of tumour types, when patients were initiated on their first cycle of a moderately emetogenic chemotherapy regimen. However the control regimen was considered suboptimal for the treatment of delayed symptoms and evidence for use in subsequent cycles is limited.

The SMC concluded that the clinical and economic analyses submitted by the company were not sufficiently robust to gain its acceptance.