In a setback to Vertex (VRTX) Pharmaceuticals, a Scottish agency determined the government should not cover a pair of cystic fibrosis medicines over their cost, posing another challenge to the drug maker as it battles with several countries to provide coverage.

“There remained significant uncertainty around their overall health benefits in the long-term, in relation to their costs,” Dr. Alan McDonald, who chairs the Scottish Medicines Consortium, said in a statement. “In order to be able to accept these medicines the committee will need to be satisfied of their cost-effectiveness and we continue to work with the company to achieve that.”

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