The Scottish Medicines Consortium (SMC) does not recommend the use of naproxen 500mg/esomeprazole 20mg (Vimovo®) within NHS Scotland for the symptomatic treatment of osteoarthritis (OA), rheumatoid arthritis (RA) and ankylosing spondylitis (AS), in patients who are at risk for developing NSAID-associated gastric and/or duodenal ulcers and where treatment with lower doses of naproxen or of other NSAIDs is not considered sufficient.

The Drug Advice notes that combined naproxen/esomeprazole has been shown in studies to be associated with a lower incidence of endoscopic gastric ulcers than NSAID alone, and with similar improvements in pain and functioning compared to a cyclo-oxygenase-2 (COX-2) selective inhibitor.  However the submitting company did not present a sufficiently robust economic analysis to gain acceptance by SMC.