At a glance: Osteoporosis

Why is brittle bone disease in the news? NICE has just finished consulting on the treatment of osteoporosis in people who have already had a fracture.

Which pharma companies will be looking on anxiously?

Merck Sharp & Dohme (MSD), Procter & Gamble (P&G) and Eli Lilly will be among those watching with particular interest.

What’s in store for them?

Under NICE proposals revealed at the end of last year, those drugs widely used against bone-thinning – MSD’s Fosamax, plus P&G’s Didronel and Actonel – would be available only to 65-year-olds who had broken a bone.

Did that go down well?

Not with the National Osteoporosis Society (NOS), which called NICE’s plans ‘ludicrous’ last time round (PRWeek, 16 January). It argued too many people under that age would slip through the net and suffer.

But NICE has revised its plans?

Yes. Now it is suggesting targeting treatments at those at the highest risk of breaking more bones by assessing their bone density and taking major risk factors into account. The NOS says this is an improvement.

Is osteoporosis that major a problem?

Not if you’re under 50. But above that age, it affects one in three women and one in 12 men.

Where does Eli Lilly come into the equation?

It produces Forsteo, a drug that grows bones, but the NOS has said it’s not sure about NICE’s plans for its use.

What does the NOS think of Forsteo?

The NOS believes it’s a ‘very good’ treatment – but NICE says it should only be available to people over 65 who have already suffered two fractures and are at further risk of injury. The NOS thinks that, despite the £5,000 cost of a course of treatment, this makes it available to too narrow a band of potential sufferers.

Anything else we should know?

Lilly is facing a civil inquiry into the way it has promoted its osteoporosis drug Evista – but only in the US. In the UK, NICE is planning consultations on the primary treatment of osteoporosis later this year.

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