Question to the Department of Health and Social Care:

To ask Her Majesty’s Government what is the cost to the National Health Service of bisphosphonates and whether they will take steps to encourage the National Institute for Health and Care Excellence to consider the evidence base for the prescription of these drugs in treatment of early stage breast cancer.

The net ingredient cost of prescription items dispensed in the community in England for bisphosphonates¹ in 2014, was £16.813 million².

In secondary care, the cost in 2014 was £35.841 million³.

The National Institute for Health and Care Excellence (NICE) has published clinical guidelines on early and locally advanced breast cancer and advanced breast cancer, published in February 2009, and familial breast cancer published in June 2013. NICE periodically reviews its guidance to take account of new and emerging evidence.

A copy of these clinical guidelines are attached.

¹ Bisphosphonates are defined as those included in paragraph 6.6.2 (Bisphosphonates and other drugs affecting bone metabolism) of the British National Formulary (BNF) but excluding denosumab and strontium ranelate.

² Source: Prescription Cost Analysis (PCA) provided by the Health and Social Care Information Centre

³ Source: Hospital Pharmacy Audit Index (HPAI) provided by IMS Health