We are calling for further review to guarantee Scotland “stays ahead” on access to bisphosphonates.

Wednesday 14 March 2018      Scotland
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We have welcomed news that Scotland is leading the UK in unlocking access to a cheap off-patent drug that can be used to help save lives from breast cancer. 

In a response to a Parliamentary Question, Health Secretary Shona Robison confirmed that all Health Boards in Scotland “routinely offer bisphosphonates to post-menopausal women with primary breast cancer who are deemed to be at high risk of recurrence, in order to help reduce the risk of breast cancer spreading.” 

Scotland is the first country in the UK where bisphosphonates will be routinely offered to all post-menopausal primary breast cancer patients at high risk of recurrence. Bisphosphonates are low-cost, widely available drugs used to strengthen bone in osteoporosis and other conditions. 

A ground-breaking analysis published in The Lancet in 2015 showed that the drug can reduce the risk of breast cancer spreading to the bone - where it becomes incurable - within 10 years by 28%. 

NICE in England has recently consulted on guidelines including the use of bisphosphonates, and access across the country is far from uniform.  Bisphosphonates are used in this indication in two of three cancer centres in Wales and Northern Ireland are still to announce how they intend to make bisphosphonates available. 

We are calling on the Scottish Government to keep guidance under review with research indicating that giving bisphosphonates to all post-menopausal women with primary breast cancer -  not just those at high risk of recurrence - could prevent one in ten deaths from breast cancer.  

We estimate that if all postmenopausal women with primary breast cancer in Scotland were offered bisphosphonates, over 100 breast cancer deaths could be prevented, saving the NHS in Scotland around £600,000 per annual cohort of patients. 

The announcement follows a long-standing campaign from Breast Cancer Now to highlight the benefit of these drugs and call for guidance to be put in place that would support health boards to prescribe bisphosphonates to all patients who could benefit. 

Lawrence Cowan, Scotland Manager for Breast Cancer Now, said:  

This is really positive news for breast cancer patients.   Scotland is leading the way in unlocking access to bisphosphonates to prevent more women dying from breast cancer. It is the first place in the UK where all post-menopausal women at high risk of recurrence can access these cheap, potentially life-saving drugs.

“But we believe that more women could benefit from bisphosphonates – not just those at high risk of recurrence.  

“If offered to all post-menopausal women with primary breast cancer, we estimate that these drugs could prevent over 100 deaths from breast cancer in Scotland and save the NHS around £600,000 a year. 
 
“Unlocking bisphosphonates in this way can help save lives and save money.  We hope that the Scottish Government will consider offering bisphosphonates to all women who could benefit - to make the most of this opportunity to save more lives from breast cancer.”

Cabinet Secretary for Health and Sport Shona Robison said: 

The Scottish Government is committed to supporting and continually improving patient care, and that includes ensuring repurposed drugs like bisphosphonates are available to those who need them. We share Breast Cancer Now’s ambition that by 2050, everyone who develops breast cancer will live if we all act now. It is a key part of our Cancer Strategy and we will work closely with Breast Cancer Now to make this a reality.”

Christina McKelvie, MSP raised the question in parliament.  She said:

Research holds the key to a world where everyone who develops breast cancer will live. Bisphosphonates is a prime example of how research can improve healthcare practice and provide new ways to prevent this disease. 

“It’s fantastic that the health service is responding to patients’ needs and improving on the prevention options available to people with primary breast cancer in Scotland.”