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Last Updated: Wednesday, 12 May, 2004, 09:11 GMT 10:11 UK
Pharmacists to sell heart drugs
Statins
Statins cost the NHS over 700m annually
Patients will soon be able to buy heart drugs in chemists, the government has announced.

At the moment, cholesterol-lowering statins are only prescribed to patients at high risk of cardiac disease, potentially saving 7,000 lives a year.

Experts believe hundreds more could be saved once pharmacies start selling statins over-the-counter.

But GPs are concerned the move is being considered for cost, rather than clinical, reasons.

We are committed to extending choice whenever advised that it is safe to do so
Health Secretary John Reid

Coronary heart disease (CHD) is the leading cause of death in adults in the UK.

Studies have shown that statins can reduce the risk of developing CHD by around a third over three years because they lower levels of "bad" LDL cholesterol.

About 1.8m people in England are currently taking statins. It is the most widely prescribed class of drugs, and therefore the most expensive item on the NHS drugs bill, costing the health service over 700m a year.

Prevention

Experts on the Committee on Safety of Medicines (CSM) advised the government that one statin, simvastatin, (Zocor Heart Pro) should be available without prescription in a 10mg dose across the UK.

Stains will still be available on prescription to patients classed as being at high risk of developing CHD.

The announcement follows months of consultation with experts and patient groups.

There have been no specific clinical trials to prove that over-the-counter use of Zocor is effective in the target population of people at moderate risk of heart disease
Consumers' Association spokesman
Pharmacists may offer a cholesterol or blood test, as well as asking people a series of questions about their health, before selling the drug.

The drugs will be available in chemists from July.

Health Secretary John Reid said: "By extending access to this drug we are giving people more choice about how they protect their health.

He added: "We are committed to extending choice whenever advised that it is safe to do so."

Mr Reid said the move would also enhance pharmacists' role.

Patients at moderate, as well as high, risk of heart disease, will be able to obtain statins over-the-counter.

Men between 45 and 54 and women over 55 who have a family history of CHD, who smoke, who are overweight or who are South Asian and men aged over 55 are all classed as being more likely to be at a moderate risk of developing CHD.

There are some potential side effects of taking statins, including muscle pains and liver disease, but pharmacists stress people buying statins would be advised what symptoms to watch out for.

Benefit versus risk

Professor Sir Charles George, medical director of the British Heart Foundation, said he was confident over-the-counter statins would save lives.

He added: "In order to ensure that these drugs reach the right people, patients should be encouraged to accept the offer of reliable cholesterol checks as well as taking appropriate lifestyle measures."

Dr Gillian Hawksworth, President of the Royal Pharmaceutical Society of Great Britain, said there was a "clear public health benefit" to be gained from making statins available over-the-counter.

But doctors are concerned about the plans, saying the dose may be too low to have any effect and that it may be difficult to monitor patients buying statins.

Dr John Chisholm, chairman of the British Medical Association's GPs committee, added: "If a drug treatment is worth taking it should be provided equitably and available to all patients at NHS expense and on the basis of need, not their ability to pay."

It has been suggested the drug will cost around 5 a week, compared to 6.40 for a month's prescription.

Dr James Kennedy, of the Royal College of GPs, warned: "You could have someone whose cholesterol is absolutely normal who would not only be spending money on something which had very little benefit, but they could also be putting themselves at some risk."

He said it was the first time people had been asked to pay for their own preventative healthcare.

"It's a decision that may be being made for expediency, rather than clinical reasons."

And the Consumers' Association said it was concerned that the drug was going to be offered without the GP monitoring.

A spokesman added: "Crucially there have been no specific clinical trials to prove that over-the-counter use of Zocor is effective in the target population of people at moderate risk of heart disease.

Shadow Health Secretary Shadow Health Andrew Lansley, said: "The government must listen to our calls for a public awareness campaign, confirm that it will only make statins available to pharmacies who are properly equipped, and carry out the necessary research to ensure the benefits the 10mg dose."


WATCH AND LISTEN
The BBC's Vicki Young
"The drugs are thought to save 7,000 lives a year"



SEE ALSO:
Call for higher heart drug doses
09 Mar 04  |  Health
Patients 'to buy heart drugs'
27 Apr 03  |  Health
Millions 'have high cholesterol'
06 Feb 04  |  Health


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