Scotland. The Scottish Medicines Consortium (SMC) has completed its assessment of clostridium botulinum toxin type A (Botox) and have advised NHS Boards and Area Drug and Therapeutic Committees (ADTCs) that clostridium botulinum toxin A is not recommended for use within NHS Scotland for adult patients with focal spasticity of the wrist and hand that is associated with stroke. In their press statement the SMC state that clostridium botulinum toxin A produces a localised reduction in muscle tone in patients with post-stroke hand and wrist spasticity and may improve disability. However, the place in therapy was not clearly defined nor was the economic case proven.
Reference:
Scottish Medicines Consortium Press Statement, 17 November 2003. Available from URL: http://www.scottishmedicines.org