Final appraisal documents on primary and secondary prevention for osteoporosis means that those unable to tolerate first-line generic alendronate will have to get worse to qualify for risedronate and etidronate.
A quarter of patients are unable to take alendronate, according to the National Osteoporosis Society (NOS).
Under the guidelines, patients with a T-score of -2.5 standard deviation or below are eligible for alendronate. But those intolerant to alendronate need higher T-scores to qualify for second-line treatments.
Last year, the NOS appealed against the draft appraisals which recommended alendronate as the only treatment.
‘We had hoped for real progress after our successful appeal against its previous drug appraisal,' said Nick Rijke, public and external affairs director for the NOS.
‘But NICE has now published something that does not overcome the shortcomings of its previous work - if anything this makes this worse for many thousands of patients.'
National Institute for Health and Clinical Excellence guidelines
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