‘Resist pressure to switch statins'

GPs have been urged to resist PCT pressure to switch statins if it is inappropriate for the patient.

Some PCTs are denying GPs prescribing incentives unless they switch patients to cheaper generic statins.

Following last week’s meeting of DoH officials and cardiovascular experts (GP, 3 November), the DoH has said it is up to individual PCTs whether or not to incentivise GPs to switch patients to low-cost statins.

GPC chairman Dr Hamish Meldrum said: ‘Most doctors will agree that there is a certain proportion of drugs that is safe to be prescribed generically. If PCTs put forward targets that mean you are encouraged to prescribe generically when it’s not appropriate, I would advise GPs not to sign up.’

Dr Graham Archard, vice-chairman of the RCGP, said that patients needed to be treated appropriately, ‘not just on the whim of a PCT.’

If somebody provides a medication that is not appropriate just because the PCT says so, they are liable,’ he said.

Data from the NHS Institute for Innovation and Improvement showed that if every PCT in England (before the October 2006 re-organisation) ensured 69 per cent of patients on statins were given low-cost drugs, over £84.7 million would be saved annually. PCTs have been told to analyse statin prescribing data down to GP practice level to ensure low-cost statins are used where possible. In Wyre Forest PCT, almost 83 per cent of patients on statins were given simvastatin or pravastatin in the first quarter of 2006/7. Paul Lynn, spokesman for Worcestershire PCT, which encompasses what was Wyre Forest PCT, said this was because the PCT’s prescribing incentive scheme has included switching to simvastatin since it became generic in 2003.

Ealing PCT in south London has also made switching compulsory for GPs. It could save over £1.15 million a year if 69 per cent, rather than 49 per cent, of patients on statins received low-cost drugs.

Rochdale PCT had the smallest proportion of patients receiving low-cost statins at 19 per cent. It is estimated that it could save over £1.2 million if it met the 69 per cent target. It has started auditing statin prescribing patterns.


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