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The waiting game

Nicotinic acid 'suitable for routine use' in CHD patients

Nicotinic acid is cost-effective enough at reducing CHD events to be recommended for routine use in the UK, a new study concludes.

Adding the drug to a statin in patients who had achieved LDL targets but had low HDL fell 'well within' the NICE outer threshold for cost-effectiveness, the modelling research found.

And the intervention was 'highly cost-effective' in patients with diabetes, according to the study, published early online by the British Journal of Cardiology.

Dr Stèphane Roze, who led the UK/Swiss study as principal researcher at the Center for Outcomes Research in Basel, Switzerland, said: 'In the UK setting, the addition of prolonged-release nicotinic acid to statin therapy resulted in long-term reduction in CHD events and increased life expectancy.

'Thus, adding PR nicotinic acid to statin therapy in these patients is clinically effective and cost-effective and could be recommended for routine use.'

Adding in nicotinic acid to a statin gave a QALY of £20,915 overall – with only a slight increase in incremental cost-effectiveness ratio from statin monotherapy. It was particularly cost-effective in diabetes patients.

Dr George Kassianos, CHD lead for Bracknell Forest PCT, said 'future guidelines would put a lot more weight' on HDL.

But Dr Rubin Minhas, CHD lead for Medway PCT and a GP in Gillingham, cautioned: 'We need to explore these findings within a real trial to see if they can be realised in practice.'

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