More people in the UK at risk of heart disease should be taking statin medicines, according to new guidance from the National Institute for Health and Care Excellence (NICE).
The health watchdog last week confirmed an earlier draft recommendation to lower the threshold for people to be prescribed statins from those with a 20 per cent risk of developing cardiovascular disease (CVD) over 10 years to those with a 10 per cent risk.
The new guidance means up to 4.5 million NHS patients could eligible to take statins to lower cholesterol in the blood and reduce the risk of heart attack and stroke.
Extra statin use would drastically benefit both the economy and society, according to NICE, with one in three deaths attributed to CVD. The NHS is estimated to spend about £8bn on CVD each year.
The decision has been influenced by the availability of generic atorvastatin, a hugely successful statin that was originally developed by Pfizer as Lipitor and is the biggest selling prescription drug in history.
Since losing patent protection in 2012, much cheaper generic versions have become available, allowing healthcare systems to reduce their spend on the medicine.
The NICE guidance specifically recommends that GPs start statin treatment for the primary prevention of CVD with atorvastatin 20mg while patients with established CVD, type 1 diabetes or type 2 diabetes should be offered a higher strength 80mg dose of atorvastatin.
However, NICE also acknowledges not everyone with a 10 per cent or greater risk of CVD within 10 years needs to take a statin and the guideline advises that preventative lifestyle measures are adopted first.
“The overwhelming body of evidence supports their use, even in people at low risk of CVD,” said Mark Baker, director of the Centre for Clinical Practice at NICE, explaining the decision. “The effectiveness of these medicines is now well proven and their cost has fallen.”
Despite these claims, NICE has come under criticism for the revised guidelines, with a Sunday Express story published in March this year claiming the experts behind the guidance were ‘in the pay’ of the pharma companies who manufacture statins.
However, this article – which failed to mention the introduction of generic atorvastatin – was firmly rebuked by NICE, with the agency stating that every member of the expert panel declared their interests and that these were publicly available.