Asked by: Baroness Altmann (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what estimate they have made of the potential cost savings to (1) the NHS, and (2) employers, in the next 20 years as a result of early detection and treatment of osteoporosis.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
We have made no estimate of the potential cost savings to the National Health Service, and to employers, in the next 20 years as a result of early detection and treatment of osteoporosis.
Information on the number of working days lost each year that result from bone fractures is not available. The Office for National Statistics (ONS) Sickness absence in the United Kingdom labour market publication is produced from data collected from the Labour Force Survey; however, this survey does not specifically ask the question of sick days taken due to fractures.
A document is attached with tables showing, firstly, the number of deaths where bone fractures were the secondary cause of death, by broad age group and sex, registered between 2014 and 2023 in England and Wales; and secondly, the number of deaths involving bone fractures, by broad age group and sex, registered between 2014 and 2023 in England and Wales.
Government will continue to consider options for further work to support those with osteoporosis and at risk of fractures, including working together with NHS England to explore supporting the provision of fracture liaison service.
Asked by: Baroness Altmann (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what estimates they have made of the number of (1) deaths and (2) working days lost, each year that result from bone fractures among (a) women, and (b) men.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
We have made no estimate of the potential cost savings to the National Health Service, and to employers, in the next 20 years as a result of early detection and treatment of osteoporosis.
Information on the number of working days lost each year that result from bone fractures is not available. The Office for National Statistics (ONS) Sickness absence in the United Kingdom labour market publication is produced from data collected from the Labour Force Survey; however, this survey does not specifically ask the question of sick days taken due to fractures.
A document is attached with tables showing, firstly, the number of deaths where bone fractures were the secondary cause of death, by broad age group and sex, registered between 2014 and 2023 in England and Wales; and secondly, the number of deaths involving bone fractures, by broad age group and sex, registered between 2014 and 2023 in England and Wales.
Government will continue to consider options for further work to support those with osteoporosis and at risk of fractures, including working together with NHS England to explore supporting the provision of fracture liaison service.
Asked by: Baroness Altmann (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether they intend to announce funding for improved fracture liaison services across England to avoid a postcode lottery relating to early detection of osteoporosis.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
Fracture Liaison Services (FLS) are commissioned by integrated care boards (ICBs) which are well placed to make decisions according to local need. NHS England is also supporting requests from health systems to introduce FLS and other secondary fracture prevention services, including through the Falls and Fragility Fracture Audit Programme.
On 24 January 2023, we announced our plan to publish the Major Conditions Strategy. This strategy will explore how we can tackle the key drivers of ill-health in England, reduce pressure on the National Health Service and reduce ill-health related labour market inactivity. The Strategy will focus on six major groups of conditions including musculoskeletal conditions, such as osteoporosis, and will be published early next year.
As stated in the Major Conditions Strategy: Case for change and our strategic framework, the Government will work together with NHS England to explore supporting the provision of fracture liaison services. The framework was published on GOV.UK on 21 August 2023 in an online-only format.
Asked by: Baroness Altmann (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they have taken to prioritise early detection of osteoporosis in older adults, especially women, and to enhance the timely diagnosis and treatment of people with osteoporosis, following ministerial commitments to do so.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
On 24 January 2023, we announced our plan to publish the Major Conditions Strategy. The Strategy will focus on six major groups of conditions, including musculoskeletal (MSK) disorders such as osteoporosis.
We have now published our initial report ‘Major conditions strategy: case for change and our strategic framework’, which is available on GOV.UK in an online-only format. It sets out what we have learned so far, and shares what we plan to focus on next to develop the final strategy.
For MSK conditions, it sets out that we will look to aim to improve services where medical treatment is necessary. Together with NHS England, we will explore supporting the further provision of fracture liaison services. This could include identifying people at risk of further osteoporotic fragility fracture and implementing strategies to reduce the risk of future fracture, including falls, and mortality.
Asked by: Baroness Altmann (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the finding from the National Institute for Health and Care Excellence (NICE) that "Evusheld is not recommended for vulnerable adults who are at high risk of severe COVID-19 because there is not enough evidence of its effectiveness against current variants and those likely to be circulating in the next 6 months", what consideration they have given to using human-derived convalescent plasma for immune compromised individuals; and what trials they have undertaken, if any, to test its effectiveness.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
For treatment of patients with COVID-19, the REMAP-CAP and RECOVERY trials both found convalescent plasma did not provide any benefit to the overall patient group. However, detailed analysis within subgroups of the REMAP-CAP data found there was a likelihood that people who are immunosuppressed may benefit from convalescent plasma with very high antibody levels - unfortunately there was insufficient data for a definite result. Consequently, REMAP-CAP has now decided to reopen the convalescent plasma arm to collect more data.
Further research is needed to determine the benefit of using human-derived convalescent plasma, or products derived from it, for immunocompromised individuals before this could be approved and available to patients. The Department commissions research through the National Institute for Health and Care Research (NIHR). NIHR welcomes funding applications for research into any aspect of human health, including immunoglobulins and convalescent plasma.
Asked by: Baroness Altmann (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to (1) the Written Answer by Lord Markham on 20 February (HL5171), and (2) the conclusion from the National Institute for Health and Care Excellence (NICE) that "Evusheld is not recommended for vulnerable adults who are at high risk of severe COVID-19 because there is not enough evidence of its effectiveness against current variants and those likely to be circulating in the next 6 months", what steps they will now take to ensure that immunocompromised individuals have access to passive immunisation via relevant human-derived antibody products from convalescent plasma, instead of through monoclonal antibody treatments.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
For treatment of patients with COVID-19, the REMAP-CAP and RECOVERY trials both found convalescent plasma did not provide any benefit to the overall patient group. However, detailed analysis within subgroups of the REMAP-CAP data found there was a likelihood that people who are immunosuppressed may benefit from convalescent plasma with very high antibody levels - unfortunately there was insufficient data for a definite result. Consequently, REMAP-CAP has now decided to reopen the convalescent plasma arm to collect more data.
Further research is needed to determine the benefit of using human-derived convalescent plasma, or products derived from it, for immunocompromised individuals before this could be approved and available to patients. The Department commissions research through the National Institute for Health and Care Research (NIHR). NIHR welcomes funding applications for research into any aspect of human health, including immunoglobulins and convalescent plasma.
Asked by: Baroness Altmann (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure that immunocompromised people for whom vaccination is not suitable are protected against COVID-19.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
Those who are at higher risk of serious outcomes from COVID-19, including the immunosuppressed and/or immunocompromised, remain a priority for the Government and as such are offered enhanced protections and interventions such as treatments, vaccines, and public health advice. The Government recently updated the online-only COVID-19: guidance for people whose immune system means they are at higher risk on 30 January 2023.
In rare cases where people may have a medical contraindication to currently available COVID-19 vaccines, individuals are able to access services such as a referral to an allergist or other appropriate specialist, to consider administration of the implicated mRNA vaccine under medical supervision in a suitable environment. When mRNA vaccines are not considered clinically suitable, the Novavax COVID-19 vaccine Nuvaxovid, a protein subunit vaccine, may be used as an alternative for people who are contraindicated against and cannot have any alternative clinically suitable United Kingdom-approved COVID-19 vaccine. The Government continues to be guided by the independent Joint Committee on Vaccination and Immunisation on the COVID-19 vaccination programme.
Immunosuppressed individuals are also a priority cohort for research into therapeutic and prophylaxis treatments such as monoclonal antibody therapies, novel antivirals, and repurposed compounds.
The Government has made available a range of new treatment options within the community for National Health Service patients at greater risk from COVID-19. These treatments are licensed for use in non-hospitalised patients to reduce the risk of hospitalisation and death.
There are two ways for clinically eligible patients to access these new treatments. Those in the highest risk group from COVID-19 with a positive COVID-19 test result can access the treatments directly, following advice from a clinician at a COVID Medicines Delivery Unit. In addition, oral antiviral treatments are available through the national study, PANORAMIC, run by the University of Oxford. This study is open to clinically eligible individuals living anywhere in the UK. Further details about eligibility can be found on the PANORAMIC website in an online-only format.
Asked by: Baroness Altmann (Non-affiliated - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the decision by regulatory authorities in the United States of America to disallow further use of the Evusheld monoclonal antibody product; and what steps they will take to ensure appropriate prophylaxis and treatment against COVID-19 for vulnerable immunodeficient and immunocompromised patients.
Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)
The Antivirals and Therapeutics Taskforce engages with other nations to share learning on the use, deployment and evaluation of therapeutics and antivirals. Evusheld (tixagevimab and cilgavimab) has a conditional marketing authorisation in the United Kingdom for the pre-exposure prophylaxis of COVID-19 and has been referred to the National Institute for Health and Care Excellence (NICE) to make recommendations for the National Health Service on whether it should be routinely funded by the NHS based on an assessment of clinical and cost effectiveness.
The final outcome of NICE’s evaluation on the use of Evusheld as a pre-exposure prophylactic treatment against COVID-19 is expected in April 2023.