Earlier this week the Scottish Medicines Consortium (SMC) rejected NHS funding for four new therapies, including Bristol-Myers Squibb and Roche’s cancer medicines Opdivo and Gazyvaro. If you don’t know, those are pretty popular drugs. Opdivo recorded $1.2B in worldwide sales in the 2nd quarter of 2017 (that’s ~$13.3M per day). The reason for the rejections? Lack of evidence that the price justified the effectiveness (vs. current treatments). The SMC’s decisions mirror those made by NICE, which rejected their use in England and Wales. Hard to argue with the logic, but we just can’t help but ask; If these medicines were made by Scottish drug makers, would they be approved? Because we all know, if it’s not Scottish, it’s crap. Either way, drug makers better bring their cost-effectiveness A-game if they want future approvals.