In 2005, the National Institute for Health and Care Excellence (NICE) in England and Wales provided new guidance on the use of anti-osteoporosis therapies for the prevention of additional fractures in patients who had experienced osteoporotic fractures, which was followed by market authorization of a generic form of alendronic acid.
A National Institute for Health Research (NIHR)-funded analysis of hip fracture patients indicates that publication of the NICE guidance and the availability of generic alendronic acid led to a nearly 15% increase in prescribing of anti-osteoporosis medication and a 14% decline in subsequent fractures in the hip, pelvis, proximal-humerus, rib, spine, or wrist/forearm over a period of 3 years. Considering only hip fractures, there was a 22% reduction in fractures.
"It is clear that the guidance coupled with the availability of a low cost bisphosphonate treatment drove a major change in prescribing by general practitioners. It is unclear how much this was due to the new guidance and how much due to generic alendronic acid arriving on the market, but it is notable that prescriptions for alendronic acid clearly outstrip those for other treatments, suggesting that it had a part to play," said Associate Professor Andrew Judge of the NIHR Musculoskeletal Biomedical Research Unit at the University of Oxford, who is co-senior author of the Journal of Bone and Mineral Research analysis.