UK doctors should prescribe more statins to help prevent cardiovascular disease (CVD), according to new draft guidance from the National Institute for Health and Care Excellence (NICE).
The change follows the loss of patent protection for Pfizer’s blockbuster statin Lipitor (atorvastatin) and the subsequent entry of much cheaper versions onto the market.
“The guideline is being updated in part to allow consideration of new evidence on CVD risk assessment tools and to reflect changes in the price and availability of generic statins,” NICE explained.
The Institute, which provides healthcare guidance for the NHS in England and Wales, says the cholesterol-lowering medicines should be used in patients with a 10 per cent risk of developing CVD over 10 years, rather than the current risk level of 20 per cent.
The proposed guidance, which is now out for consultation, also recommends cutting other risk factors, such as lack of exercise and poor diet, advises prescribers not to underestimate CVD risk in patients with conditions such as HIV and mental health problems.
It is thought that about 7 million people in the UK are currently on a statin, at a cost to the NHS of £450m a year, but this drugs bill has been trimmed considerably in recent years following Lipitor’s patent expiration.
It’s a trend NICE is keen to take advantage of, as it’s the director of its Centre for Clinical Practice Professor Mark Baker acknowledged: “The effectiveness of these medicines is now well proven and their cost has fallen.”
By expanding use of these drugs to even more patients, NICE hopes to cut levels of CVD, which includes heart disease, stroke and peripheral arterial disease and is responsible for 180,000 (one in three) deaths in the UK each year.
Doctors will need to make a judgment on whether patients now fit into a 10 per cent risk level of developing CVD, potentially leading to many more millions of NHS patients on a statin.
NICE has the draft guidance available for consultation on its website. Comments are invited until March 26, 2014, before further guidance is issued.