Caution warned on statins over the counter

NHS chief executive Simon Stevens has announced that high dose statins could be made available directly from high street pharmacies as part of the NHS Long Term Plan.

England’s top pharmacist Dr Keith Ridge and newly-appointed director of primary care, Dr. Nikki Kanani, will analyse how the cholesterol-busting drugs could be provided by high street chemists.

It’s estimated that as many as two-thirds of people most at risk of heart attack and stroke do not take statins, but would benefit from doing so. NHS bosses claim that making the most effective and powerful versions safely available, without a doctor’s prescription, could prevent thousands more deaths and countless more heart attacks and strokes.

However, the Royal College of GPs has questioned the proposed change, saying it could lead to people being misdiagnosed and wrongly treated by pharmacists. The British Heart Foundation is reported to also have concerns about whether it is appropriate to give people statins in such circumstances, before they have discussed their health with their GP, and whether pharmacists are the right people to take on this new role.

Stevens said: “Pharmacists are highly trained health professionals who are greatly valued by patients. Since the NHS will be funding local chemists to undertake health checks, it makes sense to consider whether there are a broader range of medicines that patients could access conveniently and locally on the high street.

“So the NHS will now work with the MHRA and industry to see how we can best make this happen. After cancer lung scanning trucks in supermarket carparks and High Street heart checks, this is another step towards making care and treatment more accessible, convenient and effective.”

Helen Stokes-Lampard, chair of the Royal College of GPs, said: “Extensive medical evidence has shown that statins are usually a safe and effective preventative measure against heart disease, and thousands of patients already benefit from statin therapy. But GPs are also mindful of the risks of overdiagnosis and over-treatment – a concern we expressed in response to recent NICE guidelines that lowered the threshold for eligibility of statins – and we also have concerns about making these drugs more easily accessible, without a prescription.

“Statins, like any medication, have associated risks, and GPs will only prescribe them if we think it is in the best interests of an individual patients, based on their individual circumstances – and after a frank conversation about the potential risks and benefits. Nevertheless, it is encouraging that NHS England are conducting this review before implementing a new initiative, and the College looks forward to feeding into it. Prevention is important, but it is essential that any NHS intervention to promote it is evidence-based, and in the best interests of patients.”

The review comes as the NHS is introducing heart checks on the High Street as part of the new £13 billion five-year contract for community pharmacists.