Abraxane has been shown to increase survival from pancreatic cancer by almost two months on average, and it is routinely available to patients in England. It is prescribed to patients whose cancer has already spread beyond the pancreas.
However, the Scottish Medicines Consortium said it was not cost-effective to recommend the drug for use on the NHS.
The drug costs £8856 per patient for a full course of treatment consisting of four cycles. The gross impact on the medicines budget was estimated to be £327,000 in the first year, rising to £655,000 within five years.
Pancreatic cancer has been largely neglected by pharmaceutical firms in comparison to other forms of the disease, so the decision to reject Abraxane - the first new drug against the disease in 17 years - has come as a blow to patients and campaigners.
Alex Ford, chief executive of Pancreatic Cancer UK, said: "Given that most patients are diagnosed at a point when the disease is too advanced to treat, the negative SMC advice on Abraxane could potentially affect a significant number of patients with the disease each year."
Pancreatic cancer is the fifth most common type in Scotland and rates are increasing, driven by an aging population and improved detection. In 2012, 770 new cases were identified, up 14% on 2002, with the disease claimed 742 lives in the same year.
It has one of the worst prognoses, largely because the early symptoms are difficult to distinguish from more common digestive ailments, such as irritable bowel syndrome, abdominal and back pain.
Most sufferers are diagnosed when the disease is already advanced, and fewer than one in six Scots diagnosed with the disease will live longer than a year. Cases peak among those aged over 45.
The drug's manufacturer, biopharmaceutical company Celgene, has promised to resubmit plans in an attempt to have the drug reconsidered.
Vice-president Sam Pearce said: "We are committed to exploring all opportunities to ensure patients in Scotland can access this treatment and hope to re-submit to the SMC within the next few months."
Jackson Carlaw, health spokesman for the Scottish Conservatives, said the drug manufacturer and the watchdog should negotiate an affordable tariff for the drug. He said: "If this drug has been rejected initially on cost grounds, there is now a further opportunity to review it and urge the SMC and the manufacturer to reach early agreement to ensure patients do not lose out."
The latest decision flags up a cross-Border divide in access to new cancer drugs, with patients in England able to access Abraxane already through its ring-fenced Cancer Drugs Fund.
There are hopes patients in Scotland may eventually obtain Abraxane as a result of a continuing shake-up in access to end of life drugs and so-called orphan medicines, for rare conditions. However, in the meantime, patients north of the Border will have to apply for it on the NHS on case-by-case basis through their consultants.
A spokeswoman for the Scottish Government said: "These changes are in place for medicines put forward to the Scottish Medicines Consortium from April this year.
"Although the manufacturer of abraxane put forward this submission ahead of the new process being in place, we would encourage a resubmission and that the manufacturer consider a patient access scheme to improve the cost effectiveness of this medicine."
A spokesman for the SMC said: "We recognise how devastating this condition is for patients and that this decision will come as a disappointment. SMC is putting in place a change to the way it evaluates end of life medicines and medicines to treat very rare conditions. We would welcome a resubmission that would allow the medicine to be considered under this new process."