High dose ‘statins’ could be made available directly from high street pharmacies in a new move to cut heart disease and stroke.
Statins are a group of medicines which can help lower the level of ‘LDL cholesterol’ – often called ‘bad cholesterol’ – in the blood. LDL cholesterol is produced in the liver and is potentially dangerous as it can lead to hardening and narrowing of the arteries and cardiovascular disease, which is the most common cause of death in the UK.
High dose statins are prescribed for patients with a range of diagnosed conditions, but it is believed millions more could benefit from taking a daily tablet if they were more widely available. This could dramatically lower the level of serious illness and fatalities from heart disease and stroke, and cut the huge financial burden on the NHS of dealing with these conditions.
Now a new NHS review is under way looking at how high dose statins could be provided over the counter by local chemists. Low-dose statins can already be bought without prescription, but they are less effective and generally not made available by pharmaceutical companies.
More effective and powerful high dose statins are currently only available with a doctor’s prescription. However, it is estimated that as many as two-thirds of people most at risk of heart attack and stroke do not take statins and would benefit from doing so. The drugs have been shown to be effective, with only minimal side-effects, and even a small reduction in cholesterol achieved by taking statins is able to save lives.
Recent research from Cambridge University, funded by the British Heart Foundation, suggests the benefits of statins are potentially even greater than previously reported. The new NHS review will present its findings to government health watchdog the Medicines and Healthcare products Regulatory Agency (MHRA). It will have the final say on whether high dose statins should be made more widely available without prescription.
Announcing the new review, NHS chief executive Simon Stevens said: “Pharmacists are highly trained health professionals who are greatly valued by patients. Since the NHS will be funding local chemists to undertake health checks, it makes sense to consider whether there are a broader range of medicines that patients could access conveniently and locally on the high street.”
The NHS review is being led by chief pharmaceutical officer Dr Keith Ridge and director of primary care Dr Nikki Kanani. Dr Ridge explained: “Used appropriately, statins are effective and can save lives. Hundreds of thousands of people could benefit if industry committed more research and investment in bringing high-dose statins to the high street.”
Although high cholesterol can run in families, it is often caused by consuming too much fatty food, not taking enough exercise, being overweight, smoking and drinking too much alcohol. People at high risk of cardiovascular disease are first offered lifestyle advice to lower their cholesterol, and if that is not effective, they are then offered statins.
One concern is that if high-dose statins were widely available, some people might take them instead of making positive lifestyle changes – seeing the drug as a ‘magic pill’ which allows them to continue living an unhealthy lifestyle while still cutting their risk of heart disease and stroke. Health professionals stress this is not the case and that statins are most effective when combined with a healthier lifestyle.
Even so, if only 45% of people with a high risk of cardiovascular disease were identified and treated, 6,000 strokes and heart attacks could be avoided over the next 10 years. Conditions like heart failure and stroke require treatment costing the NHS more than £7 billion every year, with knock-on effects worth around £16 billion due to the life-long impact and disability.