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Last Updated: Wednesday, 12 May, 2004, 12:43 GMT 13:43 UK
Q&A: Heart drugs
Statins will be sold over-the-counter
Patients are to be able to buy cholesterol-lowering drugs from chemists, the government has announced.

BBC News Online looks at the thinking behind the move and what it will mean for patients.

Q. What does this decision mean?

The announcement concerns a statin called simvastatin (Zocor Heart Pro). It will be sold in chemists from July this year.

Statins reduce the risk of developing coronary heart disease by lowering levels of "bad" LDL cholesterol.

Currently, only patients believed to be at a high risk of developing CHD can obtain statins on prescription.

But experts have advised the government that people at moderate risk could benefit from a low-dose of this particular statin over-the-counter.

Q. Why are they doing this?

Coronary heart disease is the biggest killer of adults in the UK. Premature deaths from heart disease and stroke have fallen by 23% over the past five years.

Statins are currently prescribed to 1.8m people in England, and are thought to save 6-7,000 lives a year. The government believes that many more could be saved by making the drug more widely available.

Q. Should I be taking statins?

There are several factors which suggest people are likely to have a moderate risk of developing CHD and could therefore benefit from the medication.

These are :-

    Men over 55
  • Men aged 45 to 54 and women over 55 who have one or more of the following risk factors - a close relative who has had CHD, are a current or recent smoker, are overweight or of South Asian Ethnicity.

Pharmacists will interview people who want to buy statins to see if they meet these criteria, and to check they are not taking other drugs which the statin could interact with.

They may also offer blood and cholesterol checks.

Q. Is the drug safe?

There are some very rare side effects associated with the statin, such as muscle pains and liver disease, but pharmacists will be trained to warn people taking the drug what to watch out for.

However, the information on risks and benefits has come from studies of high-risk patients taking high doses, and some bodies - including the Consumers' Association and the Royal College of General Practitioners (RCGP) - say they are concerned the drug has not been tested on the group of people it is going to be sold to.

They fear that, while the benefits outweigh the potential risks for sicker patients, people with a relatively low chance of developing CHD may be unnecessarily risking the side effects of the drugs.

Q. How much will it cost?

There has been no official announcement yet on how much the statin will cost, or how much people will be able to buy at one time.

However, the RCGP has estimated it could cost around 5 a week. Prescriptions -which cost 6.40 - usually contain a month's supply of medication.

Statin prescriptions currently cost the NHS 700m a year.

Q. If it will reduce the risk of heart disease, why isn't the NHS funding the treatment?

Patients at high-risk - classed as over 30% - will still be able to obtain statins on the NHS. Doctors will also be able to prescribe to patients at lower risk, if they feel they would benefit.

The government says making the drug available over-the-counter will allow people at low to moderate risk to act to protect their own health.

Q. Will taking statins encourage people to live an unhealthy lifestyle?

There are concerns that people could see popping a pill as an easy option.

But the British Heart Foundation emphasises that people still need to stop smoking, control their weight, eat a balanced diet and take more exercise to reduce their risk of heart disease.

Pharmacists will also offer healthy living advice when people buy the drug.

Q. So, does everyone agree this is a good idea?

While no-one is against more people benefiting from medication, the RCGP is concerned about how people buying statins from chemists will be monitored.

Doctors also say that if a drug has been found to be of benefit to people, it should be available to all on the NHS.

Niall Dickson, chief executive of the King's Fund, said: "The cost of statins should not be passed from the NHS onto the patient.

"There is a real danger that people on low incomes who face a less than 30% chance of a heart attack or stroke in the next 10 years, but who would have to pay for these drugs, would not have the money to do so."

Pharmacists to sell heart drugs
12 May 04  |  Health

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