The treatment of osteoporosis

The guidance that NICE has recently produced on the treatment of osteoporosis must come as a huge disappointment to sufferers who cannot take, or fail to respond to, Alendronate.

I understand that the final appraisal determination on treatment for the primary and secondary prevention of osteoporosis represents a significant improvement on NICE’s previous draft appraisal. However, I appreciate that many people will have concerns about NICE’s decision to recommend that Alendronate is provided as a treatment option, while not recommending other treatments, including Etidronate, Risedronate, Raloxifine and Strontium Ranelate.

NICE is an independent body tasked by the Government to decide which drugs and treatments should be available on the NHS in England and Wales. It has to take into account the drug’s clinical and cost effectiveness. These decisions are always going to be hard to make and some will be very finely balanced.

I should say that I respect the independence of NICE. I believe that it is right that calls on the Health Service budget are made by experts, rather than by politicians. The decision over which drugs should be made available on the NHS should be as free from political interference as possible, since otherwise we will end up in a situation where the power of lobbying groups dictates which conditions should receive the most funding. The only criteria for assessing drugs should be their cost effectiveness and their clinical effectiveness.

That said, NICE must be held accountable. I do understand that there is a great deal of concern about how NICE undertakes its work. I will continue to press the Government to ensure that NICE conducts its work as openly, as quickly and as effectively as possible.

 

August 2007