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I would like to make some comments following your coverage of the NICE draft statins document (June 25).

The NICE statins guidance should be welcomed for bringing thresholds for primary prevention in line with guidelines in Europe and the US ­ it is the Joint British Societies (JBS) thresholds which will be out of kilter. As the JBS guidelines are not in the public domain, comparison and criticism of NICE guidance seem harsh.

The JBS guidelines have not previously attempted to justify the rationale for setting their threshold as NICE are transparently doing in their consultation exercise. I note the last guidelines from the JBS suggested lowering their threshold 'when resources allow' ­ rationing without providing a rationale.

I am sure many GPs around the country would welcome the NICE guidance as it reflects the implications of policy for the NHS and protects against the distortion of care provision in general practice arising from the adoption of uncosted and narrow specialist guidelines.

Dr Rubin Minhas

CHD Clinical Lead

Medway PCT

Gillingham, Kent

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