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Thousands of osteoporosis patients denied a pain-free life for £3 a week
Last updated at 07:07am on 09.10.07
The Health Service 'rationing' body wants doctors to prescribe only the cheapest osteoporosis drug, even though it does not work in many cases
Hundreds of thousands of women could suffer painful and dangerous broken bones under plans to restrict drugs for osteoporosis.
The Health Service "rationing" body wants doctors to prescribe only the cheapest drug, even though it does not work in many cases.
Medical experts say it will set the treatment of the disease back years.
Yet patients in Scotland will still have access to a full range of drugs.
Under the proposed guidelines from the National Institute for Health and Clinical Excellence, women in England and Wales who are diagnosed with thinning bones would be allowed only one drug, alendronate, which costs just £1 a week.
Alternative medications, which average around £3 a week more, could be prescribed only with the approval of cash-strapped primary care trusts.
This is despite the fact that around one in four women suffer crippling side effects from alendronate or do not respond to it.
Banning alternatives will greatly raise their risk of a serious fracture condemning them to a life of pain.
More than two-thirds of consultants oppose the move.
Campaigners fear thousands of patients will be forced to go without drugs as many PCTs are already denying them alternative treatments.
There is also evidence that some women taking other drugs are being swapped to the cheapest without their doctor's knowledge.
Osteoporosis is known as the silent epidemic because there are often no symptoms before a victim suffers a fracture.
Almost one in two women and one in five men over 50 will break a bone, and many hip fractures lead to premature death.
Professor Graham Russell, a leading expert in the field, said: "It is not in the best interests of patients to restrict choice, as going down this route will result in fewer patients being treated.
"Fractures will still occur and the costs will continue to burden the NHS.
"Another concern is that pharmacists are changing prescriptions to generic alendronate without consulting the prescriber in some areas.
"This is another example of the dumbing down of medical practice."
Professor Russell, who is the Norman Collisson Professor of Musculoskeletal Sciences at Oxford University's Nuffield Department of Orthopaedic Surgery, said the NICE proposals will set back the treatment of osteoporosis by years.
The National Osteoporosis Society has lodged an appeal against the planned guidelines, which will be heard later this month.
The society says the drug restrictions would leave hundreds of thousands of patients untreated and at risk. It says treatment would be mostly limited to people over 70.
Members of the charity, led by actress Trudie Goodwin, from the TV series The Bill, will deliver a 20,000-signature petition against the proposals to Prime Minister Gordon Brown on Thursday.
Nick Rijke, NOS public and external affairs director, said: "If the NICE guidance goes ahead unchanged, patients will be at the whim of the purse-holding PCTs.
"This is another case of postcodeprescribing, with some unlucky patients left without the bone-protecting drugs they need."
A survey of specialist consultants and GPs carried out for the charity by ICM found that just 28 per cent support the NICE guidance.
Two out of five of the 300 doctors questioned said they fear patients would receive a lower quality of care.
Dr Alun Cooper, a GP with a special interest in osteoporosis, said one in four people cannot tolerate alendronate or respond to it.
He said "There is already a huge amount of pressure on us GPs from PCTs to prescribe it but if we do this, some patients will have problems and just stop taking their treatment.
"These patients often don't come back to their GPs, so they end up with a higher than necessary risk of fracture.
"I come across a lot of practices where GPs are forced to switch patients, who are well controlled and without problems on their current treatments, to generic alendronate.
"Unchanged, the NICE Guidance is sanctioning PCTs to not actually implement a good standard of care for secondary prevention of fracture."
Alendronate belongs to a class of drugs called bisphosphonates. Others in this class - including risedronate, ibandronate and etidronat - and in some others range in price from less than 20p to £1 a day.
Other drugs, such as strontium, would cost as much as £30 a month and some even more.
A NICE spokesman said: "It is disappointing that this appeal will delay final guidance on the use of drugs for osteoporosis.
"It will delay publication of our clinical guideline which will set out the best use of drugs and non-drug treatments - such as dietary factors and increased physical activity - for individuals at high risk."
He added that, in the meantime, existing guidance will apply. This recommends alternative treatments for women who cannot take or have withdrawn from alendronate.
Reader views (5)
Here's a sample of the latest views published. You can click view all to read all views that readers have sent in.
If these pills are indeed only £3 per week just buy them, and bypass the NHS.
- Graham, St.Louis, USA
How much does it cost the NHS when one of these osteoporosis victims falls and unnecessarily breaks a major bone? It'll be more than the ordinary fracture victim, that's for sure. In fact it'll be so much, the conclusion I am forced to is that they know almost all sufferers will fund the £200 per annum for the drug that works themselves, rather than risk the consequences.
- Nigel, London
I think Zee's comments are unhelpful. Has she or he researched the time Camilla has spent? Does she or he remember that Camilla's mother suffered horribly from the disease?
Aside from that, why are English patients apparently receiving cheaper and useless drugs than Scottish patients? Do Scottish MPs vote on this? Why can we not afford them? There seems to be plenty of money for every PC cause around and yes, for Mr J Prescott's - and other civil 'servants' pensions.
- Helen, Norwich
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