Decisions on the routine availability of medicines, such as Zoledronic acid, are made locally by clinical commissioning groups (CCGs). CCGs make funding decisions based on the needs of their population. Commissioning is about getting the best possible health outcomes for the local population and this involves assessing local needs to inform priorities and strategies.
Under their terms of service, clinicians are allowed to prescribe any product which they consider to be a medicine necessary for the treatment of their patients under the National Health Service, subject to two provisos: firstly, that the product is not included in Schedules 1 or 2 to the NHS (General Medical Services Contracts)(Prescription of Drugs etc.) Regulations 2004 and secondly, that the clinician is prepared to justify any challenges to their prescribing by their local CCG.
Decisions on whether to routinely fund medicines should be taken in the context of the CCGs available resources to ensure that care is fairly allocated to all patients and, where appropriate, measured against the CCGs other service development priorities.