NICE Osteoporosis Drug Guidance Criticised
An appeal has been launched by campaigners against the National Institute for Health and Clinical Excellence's (NICE's) current standpoint on the availability of osteoporosis drugs on the National Health Service. At present, a single drug represents the choice for patients with the crippling bone disease. However, the treatment in question - alendronate - has attached side effects, which can potentially affect 25 per cent of those taking it. In the absence of other drugs, huge numbers of patients are being denied treatment that could ultimately save their lives, says the National Osteoporosis Society (NOS).
In the eyes of NOS, NICE's decision to approve alendronate, which is the cheapest drug in its class, constitutes a false economy, and places many osteoporosis sufferers in a situation where their very lives could be more at risk. Consequently, as stated by NOS spokesman - Professor Ignac Fogelman - the group is "challenging the financial model that was used to look at the cost effectiveness of the various treatments for osteoporosis."
The situation concerning alendronate was described further by GP Rosemary Leonard. "Alendronate is the one osteoporosis drug which is now off patent so it is a lot cheaper than the others which is why there is this push to prescribe it", she said.
"But unfortunately one in four people who are on it can get bad reactions to it, particularly inflammation of the oesophagus. There is a choice available but NICE guidelines say that primary care trusts (PCTs) only have an obligation to provide alendronate."
In certain PCTs, this leads to alendronate being the only available option, Ms Leonard concluded.
St Thomas Hospital's Professor Tim Spector added: "It is vital for clinicians and patients to have alternative treatments available so we can maximise patient choice, reduce avoidable drug side effects and reduce the risk of osteoporotic fractures."
NICE's ultimate guidance in respect of alendronate is yet to be issued. However, the body confirmed, in a statement:
"It is disappointing that the appeal will delay final guidance on use of drugs for osteoporosis and delay publication of our clinical guideline which will then set out the best use of drugs and non-drug treatments."
More than one million cases of osteoporosis have been identified in the UK, with, according to experts, probably a great deal more that have not yet been diagnosed.
Source - Pharmaceutical International's Health Reporter
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