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Last Updated: Thursday, 17 January 2008, 12:43 GMT
NHS overspends on statins
David Thompson
By David Thompson
The Politics Show

Doctor filling out prescription
What is the real cost behind statin prescriptions?

Statins - cholesterol-lowering drugs - are described by many as a breakthrough in the treatment of life-threatening conditions. But it has emerged that doctors waste tens of millions of pounds on buying unnecessarily expensive versions of the drug - and the Politics Show can now reveal which NHS Trusts are the worst offenders.

Imagine there was a pill you could take which could significantly reduce the risk of heart disease - one which might also help with diabetes and Alzheimer's Disease.

Well, the good news is, it exists.

The bad news? According to the NHS's own figures, millions of pounds are being wasted through the way this drug is being prescribed.

CHECK THE SPENDING ON STATINS IN YOUR REGION:

Source of statistics: NHS

Enough money, according to MP and GP Dr Howard Stoate, to pay for more than 2,000 nurses every year.

Statins are described, by some experts, as one of the major breakthroughs in modern medicine - they may reduce the risk of a heart attack or a stroke by a third.

At what price?

They work by reducing cholesterol levels and, with their use in pre-empting heart disease or treating existing conditions, they were the single biggest drug cost to the NHS in England in 2007 - 500m was spent on them.

As more and more people are prescribed them, the prediction is that that price tag will rise by 20% year-on-year.

And that throws up the problem. How does a health service which has to work on limited budgets pay for a drug which has the potential to save thousands of lives?

Surgeons
Statins take business away from the theatres

There is good news and bad news there too. Statins are becoming cheaper as time goes by.

Brand-name versions of the drug are coming out of patent, which means cheap alternatives can be made at a fraction of the cost.

Nice switch

The National Institute for Clinical Excellence (Nice) is urging GPs to switch patients from the expensive, branded versions to the cheaper generics when it is medically appropriate.

For example, a brand-name version of Atorvastatin costs 18.03 for a month's supply.

A generic version of Simvastatin, which many doctors say will do the same job for the majority of patients, costs 1.39.

Despite that, using the Freedom of Information Act, the Politics Show has found that many primary care trusts in England are still prescribing a high percentage of the more expensive statins - wasting as much as 70m a year.

Variations

Pills
Find out what your PCT is spending on statins

There are variations to this situation throughout the country.

But the high-cost prescribers tend to be clustered around the North West.

Tameside and Glossop PCT spends 17.56 per patient on statins, of which only 43% are of the low-cost generic variety.

However, there are variations within the region too.

Oldham PCT spends 15.40 per head on statins, of which less than 40% are generic.

But Blackburn with Darwen PCT, its next-door neighbour, spends 7.38 per head, with almost 80% of the statins prescribed being of the low cost variety.

No doubt both trusts have perfectly good reasons for the differences in the way they spend and prescribe, but in Westminster spending watchdogs want to see action.

Edward Leigh, Chairman of the Parliamentary Public Accounts Committee, thinks it is not good enough to say primary care trusts have the freedom to spend their budgets as they wish, absolving government from responsibility.

He says that managers who fail to buy a significant amount of generic drugs should be punished - possibly even sacked by Ministers.

Future implications

Pills
Will statins become as common as aspirin?

That might seem draconian, but Dr James Moon, a consultant cardiologist, says that as time goes on, more and more people will be prescribed statins as a preventative measure - perhaps as large a group as all men over 50.

He believes that as much as a quarter of the population could benefit from taking these drugs.

This significantly ups the ante. As more and more people are prescribed these drugs, every pound wasted could in turn deprive others from accessing and benefiting from their life-saving effects.

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