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<p>The net ingredient cost of prescription items dispensed in the community in England
for bisphosphonates<sup>1</sup> in 2014, was £16.813 million<sup>2</sup>.</p><p> </p><p>
</p><p> </p><p>In secondary care, the cost in 2014 was £35.841 million<sup>3</sup>.</p><p>
</p><p> </p><p> </p><p>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.</p><p> </p><p> </p><p> </p><p>A copy of these clinical guidelines are attached.</p><p>
</p><p><em> </em></p><p> </p><p><sup>1 </sup>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.</p><p>
</p><p><sup>2 </sup>Source: Prescription Cost Analysis (PCA) provided by the Health
and Social Care Information Centre</p><p> </p><p><sup>3 </sup>Source: Hospital Pharmacy
Audit Index (HPAI) provided by IMS Health</p><p> </p><p> </p><p> </p>
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