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Moderate-risk CHD patients will not face checks for OTC statins

Pharmacists will not have to test cholesterol levels or check liver function before selling statins to any patient at moderate risk of coronary heart disease under plans unveiled by the Government.

Health Secretary John Reid proposed that anyone with a 10-15 per cent 10-year risk of a first major coronary event (see right) should be free to buy 10mg simvastatin over the counter from next spring.

The cost of one month's supply is currently £18.03.

The Medicines and Healthcare Products Regulatory Agency said pharmacists would not have to test cholesterol because statins were beneficial regardless of the level of starting risk.

A Department of Health spokesman said simvastatin was linked to rare reports of myopathy and hepatic injury but added: 'Statins are now recognised to be so safe that there is no routine need for tests to check safety.'

But Professor Joe Collier, professor of clinical pharmacology at St George's Hospital medical school in London and editor of the Drug and Therapeutics Bulletin, said: 'It seems to me a worrying precedent that patients will effectively diagnose themselves and go on to treat themselves with lifelong drugs that do have side-effects and interactions.'

Dr John Pittard, a member of the team that wrote the CHD national service framework and a GP in Middlesex, said: 'I'm all in favour of this plan, but adequate safeguards such as liver function tests must be built in.'

RCGP prescribing spokes-man Dr Jim Kennedy said it was vital pharmacists had full access to patient notes before statins went over the counter.

GPC prescribing sub-committee member Dr Chaand Nagpaul said the plan would 'create a two-tier service', with GPs expected to tell moderate risk patients they would benefit from statins but must buy the drugs themselves.

The department spokesman said GPs should limit prescriptions to patients 'at highest risk who are eligible for statins on the NHS'. The high-risk category covers those with a 10-year risk over 30 per cent, but is expected to be widened to cover anyone with a 10-year risk over 15 or 20 per cent.

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