The Scottish Medicines Consortium (SMC) has accepted prasugrel (Efient™) co-administered with aspirin for restricted use within NHS Scotland for the prevention of atherothrombotic events in patients with acute coronary syndrome undergoing primary or delayed percutaneous coronary intervention. Use is restricted to patients who are eligible to receive the 10mg dose of prasugrel.

When compared to an alternative antiplatelet agent, prasugrel demonstrated a significant reduction in the incidence of ischaemic events, mainly non-fatal myocardial infarction, in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Prasugrel was, however, also associated with an increased risk of clinically significant bleeding events.

Alternative treatments are available at a lower drug acquisition cost.

[Editors note: The 5mg dose is licensed as maintenance treatment for patients aged over 75 years and for patients weighing less than 60kg. This patient group was excluded from the SMC analysis]