Letters, calls and emails: CHD programme provides extreme value for money

Prime minister Gordon Brown may be a desperate man who is getting ahead of himself, but the byzantine NHS has slowly been moving to cardiovascular disease (CVD) risk assessment for years.

The NSF for CHD states that there should be practice-based registers of patients at high risk, though PCTs have generally failed to deliver.

The evidence and cost-effectiveness will drive this forward. Three studies have shown that statins not only reduce CVD but also cut hospital costs.

The hospital cost savings identified in the Heart Protection Study for a patient with a 20 per cent or greater CVD risk, are about £900 over five years. Five years of simvastatin 40mg costs less than £90.

That leaves over £800 to manage each patient. The heart attacks and stokes prevented are free.

Such cost-effectiveness is almost unheard of; only some vaccination programmes come close.

Dr John Ashcroft, Ilkeston Derbyshire.

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