A number of drugs used for osteoporosis treatment will not be available to patients on the NHS unless their condition worsens, according to new guidelines.
The National Institute for Health and Clinical Excellence (Nice) has decided to stand by its original guidance, which severely limits the number of drugs that people with the bone-thinning disease osteoporosis can take without resorting to private treatment.
People will still be entitled to receive alendronate - which costs around 11p per day - but will not have access to alternative treatments unless their condition deteriorates.
This means that one in four patients who do not respond to alendronate or who experience severe side-effects will not be able to try a different drug.
Claire Severgnini, chief executive of the National Osteoporosis Society, commented: "This final set of guidance is inflexible and unethical and leaves clinicians with unnecessarily limited options to treat a condition that leads to 300,000 fragility fractures a year.
"Every patient is different and needs to be treated with the therapy that best meets their needs."
Half of women and one-fifth of men over the age of 50 fracture a bone, usually because their bones have been weakened by osteoporosis.