From Mr A. E. J. Sterry, MRPharmS
SIR,-Can anyone explain why 100 Calcichew-D3 costs the National Health Service a massive £15.02? The calcium carbonate content costs about 38p.
Even more difficult to understand is that for 100 Calcichew-D3 Forte (with twice as much vitamin D3) the price falls to £9.50.
Are the price lists correct? If so, what does Lord Hunt have to say about it?
Alan Sterry
Bristol
Mr JOHN FREEMAN (managing director, Shire Pharmaceuticals Ltd) replies: We reduced the price of Calcichew-D3 Forte on July 1, 1999, to encourage physicians to prescribe the higher dose of vitamin D contained in it (1g calcium of carbonate plus 800IU vitamin D in two tablets daily).
This decision followed publication of osteoporosis guidelines1 by the Royal College of Physicians recommending the routine use of calcium and vitamin D supplements in the frail elderly and earlier clinical studies demonstrating the benefits of this dose regimen on reduction in hip fracture in the elderly.2,3
| 1. Royal College of Physicians. Osteoporosis: clinical guidelines for prevention and treatment. London: The College; 1999. |
| 2. Chapuy M et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. New Eng J Med 1992;327: 1637-42. |
| 3. Chapuy M et al. Effect of calcium and cholecalciferol treatment for 3 years on hip fractures in elderly women. BMJ 1994;308:1081-8. |