DoH discusses national statin-switching policy

GPs could be forced to switch patients to simvastatin, following a meeting of cardiovascular experts at the DoH.

Among the items on the agenda at the meeting with Dr Stephen Green, from the DoH vascular team, was the possibility that the quality framework could be changed to force a move to the cheaper statin.

For patients on low doses of statins, prescribing simvastatin rather than atorvastatin could save the NHS more than £2 billion over the next five years (GP, 16 June).

Dr Rubin Minhas, the GP expert on the NICE statins committee, was also due to speak at the meeting, as GP went to press. He intended to encourage the statin-switching policy.

Although uncertain whether or not switching from atorvastatin to simvastatin would be included as an indicator in the quality framework, he said: ‘Clearly there is a problem in the system when there are potential annual savings of up to £1 billion, when the overall service is running at a deficit of half a million pounds.’

The savings could provide much-needed revenue for other NHS services, he said. ‘Since simvastatin has become generic, several million pounds of taxpayers money is being wasted,’ explained Dr Minhas.

‘The ethical arguments for using it are so great it’s difficult to defend any other policy.’

Although low-dose simvastatin and atorvastatin have been shown to have the same health benefits, since the patent on simvastatin expired in May 2003 the cost has plummeted and it is now six times cheaper than equivalent doses of atorvastatin.

The maximum price of simvastatin 40mg is £3.89, six times cheaper than atorvastatin 20mg at £24.64.

The DoH meeting will also hear from Dr James Moon, cardiologist at the University College of London hospital, who co-wrote a BMJ editorial in June arguing the economic case.

It was calculated that at least £2 billion would be saved over five years if simvastatin was given to the estimated 5.2 million people eligible for statin therapy under NICE guidance.

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