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At the heart of general practice since 1960

Chaos looms over at-risk flu campaign

GPs fear cuts to services as PCOs warn they will struggle to cope with soaring statin bills. Guidance to be released later in 2005 could see the number of patients eligible for statins increase by up to threefold.

The Joint British Societies are already insisting that PCOs should be budgeting to work towards a statin prescribing threshold of 15 per cent

10-year CHD risk.

And the National Prescribing Centre, which circulates prescribing information through- out the NHS, has warned PCOs 'to prepare' for new NICE guidance on statins later this year.

It follows the centre's ruling that the drugs should

be considered in all patients with type 2 diabetes (Pulse, January 8).

But PCOs said that while they were aware of the likely changes to guidance, they would find it hard to cope with the cost without siphoning funds from other areas of their budgets.

Burntwood, Lichfield and Tamworth PCT said: 'As an overspending PCT it is yet another headache.

'We are not only looking at expanding the number of patients, but also more potent statins and more combination therapy.'

Basildon PCT said: 'We are going to be under enormous financial pressure for the next few years.'

The NHS Alliance insisted any extra costs arising

from NICE recommendations should be met by the Department of Health.

But the department said no 'ring-fenced' funds for statins would be made available. It said the growth in prescribing costs of drugs due to NICE guidance was 'factored into' the annual increase in funding.

'Decisions about where money is spent are made at a local level so that they can reflect local priorities and needs,' the department said.

Dr Peter Brindle, Wellcome training fellow in health services research at the University of Bristol and a GP in the city, said: 'I am happy to prescribe statins to higher-risk patients, but not if it comes out of my pocket or it cuts the money going into the practice.'

Dr John Ashcroft, a GP in Ilkeston, Derbyshire, said a 15 per cent risk threshold would triple the number of people eligible for prescribed statins.

But he claaimed pressure on prescribing budgets would soon be relieved by a drop in the cost of simvastatin.

Statins for CHD prevention

Current guidance CHD NSF says patients with 30 per cent or greater 10-year CHD risk should receive a statin

Forthcoming guidance JBS to set minimum level of care at 22.5 per cent 10-year CHD risk, moving towards 15 per cent

Additional annual cost Up to £1.4 billion at current prices

Statins in diabetes

Current guidance NICE advises treating all patients with

LDL-cholesterol over 3mmol/litre with a statin

New guidance NPC says statins should be considered in all patients with type 2 diabetes.

Additional cost to NHS £360 million at current prices

By Cato Pedder

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