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High Court orders NICE to redraft osteoporosis guidance

By Nigel Praities

NICE has been forced back to the drawing board on its guidance for osteoporosis, after the High Court ordered the body to revaluate its appraisals of treatment for post-menopausal women.

In a judgment set to pile pressure on NICE to alter its highly controversial technology appraisals, a high court judge has ordered it to open its decision-making process to scrutiny and to consider new evidence from all stakeholders.

The judge said NICE had acted unlawfully by not releasing details of the economic model it based its guidance on, and ordered the body to publish and invite comment on it.

The judicial review is a major victory for a coalition of pharmaceutical companies and patient groups and follows a storm of protest over technology appraisals released last year by NICE.

The appraisals recommended patients who are unable to tolerate bisphosophonates must wait for their BMD to drop below T-scores of 2.5 or below before they can be prescribed an alternative to alendronate.

This approach was described by NICE's own advisers as 'out of date' and 'unworkable' and saw them recommend GPs follow rival National Osteoporosis Guidelines.

Dr Tim Spector, consultant rheumatologist at St Thomas' Hospital said the judgment was a ‘great result' for osteoporosis patients.

‘Today's court decision will provide us with the opportunity to review the guidance and the economic assumptions made by NICE. This will hopefully result in new simpler and more flexible guidance in which clinicians have a real choice in the prescribing decisions they make for women with osteoporosis, who are all individuals with individual needs,' he said.

Patient protest: judicial review a major victory Patient protest: judicial review major victory

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