Published: 04/03/2004, Volume II4, No. 5895 Page 9

The National Institute for Clinical Excellence has delayed its final decision on drugs to treat osteoporosis after doctors and patient groups condemned draft guidance for being too restrictive.

The institute last week said its independent appraisal committee had agreed to split the next stage of consultation in two as a result of the large amount of information received during consultations so far.

Draft guidance published last month had been widely criticised for refusing preventative drugs to post-menopausal women who had not yet broken a bone. Now guidance on the issue - originally due in June - will be delayed until at least the end of the year.

NICE said it would examine further data to 'enable a proper assessment of the risk factors for osteoporosis'.

'Work being carried out by the World Health Organisation, which is feeding into the NICE guideline on osteoporosis, will be pivotal to this assessment. This data is expected to be received towards the end of the year. In addition, further work needs to be carried out so that the committee can take the cost of screening for bone mineral density ... scanning into consideration in its recommendations.'

The draft NICE guidance had also been criticised for restricting the choice of drugs for women who had suffered a fracture.

Further analytical work will also take place on this issue, which will be considered by NICE's appraisal committee in April.

Heidi-Mai Warren, deputy policy manager for the National Osteoporosis Society, said the draft guidance had been too heavily influence by economic considerations. She said involvement of the institute's clinical guidelines development group on osteoporosis during the next stage of assessment should improve matters.

'We would put our trust in the guidelines development group, which is a group made up of experts in osteoporosis. In the technology appraisal committee there were no experts, ' she said.