Here you will find the recommendations we have made about the use of individual medicines in Lancashire.

Sodium oxybate

Brand: Xyrem®
Indication: Narcolepsy with cataplexy
Disease category: Central nervous system
Commissioning responsibility: CCG
PbR excluded: Yes


Sodium oxybate is not recommended for use as a treatment of narcolepsy with cataplexy. The evidence demonstrates sodium oxybate’s efficacy when used for the treatment of narcolepsy with cataplexy. There are however significant concerns, as follows:
• The only UK based cost effectiveness estimate, which was provided by the SMC, estimated sodium oxybate’s cost per QALY to be between £49,590 and £65,980. These figures and concerns that the potential costs of adverse events are not included in the costing model and that the clinical resource savings may not be realised, led the SMC to conclude that the drug was not cost effective.
• Safety issues and side effects, particularly respiratory depression are significant
• Sodium oxybate is a schedule 2 Controlled Drug with an abuse potential

November 2019 update: RMOC Midlands and East published an advisory statement on the use of sodium oxybate in October 2019. The purpose of the document is to facilitate commissioning decisions relating to sodium oxybate for all adult patients. The LSCMMG recognised in 2016 that the evidence did demonstrate sodium oxybate’s efficacy when used for the treatment of narcolepsy with cataplexy. The LSCMMG assigned sodium oxybate a ‘Black’ RAG status as there were concerns relating to cost-effectiveness, safety and abuse potential.
The additional information provided by the RMOC does not offer sufficient additional evidence to provide a basis for amending the current decision made by the LSCMMG. Therefore, sodium oxybate retains a ‘Black’ RAG status in Lancashire and South Cumbria.


LMMG recommendation: Black
Click here to find the definitions for the colour classifications

Reason for decision:  Not recommended for prescribing on the NHS in Lancashire

Supporting documents:

New Medicine Recommendation - Sodium Oxybate for Narcolepsy with Cataplexy (603.9 KiB)

Decisions of Lancashire local decision making groups:

NHS Blackburn With Darwen CCG and NHS East Lancashire CCG NHS Blackpool CCG NHS Chorley and South Ribble CCG and NHS Greater Preston CCG NHS Fylde and Wyre CCG NHS Morecambe Bay CCG NHS West Lancashire CCG