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GPs braced for surge in statin prescription demand

GPs have been warned to brace themselves for a surge in demand for statin prescriptions, amid widespread confusion over the Government's plans to make the drugs available over the counter.

With no clear guidance from the Department of Health, GPs will be left to refuse requests from patients close to the risk threshold for NHS prescription – or face conflict with their PCTs.

Under the new proposals, patients with a 10-year heart attack risk of 10-15 per cent or greater will be able to buy 10mg simvastatin OTC within a matter of weeks.

The current risk threshold for prescribing statins in the national service framework for CHD is 30 per cent over 10 years. But the man who drew up the document, Professor Sir George Alberti, thinks the four-year-old advice is out of date and GPs should prescribe from 15 per cent as advised by the British Hypertension Society (Pulse, March 15).

RCGP prescribing spokes-person Dr Jim Kennedy said: 'A number of patients will come in with a very low indication for being on a statin and will either put pressure on to get statins on prescription or will be getting them over the counter when you may not think it's in their best interest.'

Dr Strat Liddiard, a GP in Poole, Dorset, and national GP lead for the CHD collaborative, said PCTs would 'get upset' if GPs prescribed statins to patients below the 30 per cent threshold, adding: 'Sooner or later some GP will get in trouble and there'll be a furore'.

Dr Neil Amin, prescribing lead for Enfield North PCT, said there were 'a lot of unanswered questions – I've not personally received any guidance on this'.

Other GPs said they would stick to the 30 per cent risk threshold.

Statins and coronary heart disease risk

l Low (<10% 10-year="" risk)="">

Preventive treatment not indicated

l Moderate (10-15% 10-year risk)

Simvastatin 10mg obtainable from pharmacists for

primary prevention

l High (15-30% 10-year risk)

The British Hypertension Society (2004) recommends prescribing statins but also available from pharmacists

l Very high (>30% 10-year risk)

The NSF for CHD recommends prescribing statins for primary prevention of CHD only in these patients

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