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Gold, incentives and meh

Statins could save huge sum on CHD

GPs could save the NHS huge sums of money by prescribing statins and aspirin to more patients at risk of dying from heart disease before they end up needing costly surgery instead, a study has revealed.

The cost per life year gained for secondary prevention of CHD using interventions such as angioplasty and coronary artery bypass graft (CABG) was 10 times higher than statins, researchers found.

GP experts at the London School of Hygiene and Tropical Medicine said less than half of patients at high risk of heart disease were actually taking statins and some were dying on waiting lists for CABG


The study calculated the cost per life year gained for a specific intervention. The researchers found for people aged 25-84 the most cost-

effective intervention was treatment with statins at around £2,500 per life year gained. This compared with angioplasty and CABG interventions which were both more than £25,000.

Treating patients who had already had a myocardial infarction was very cost-effective at less than £1,000 per life year gained.

The study, presented last week at the Society for Social Medicine conference in Manchester, found in 2000, medical and surgical treatments prevented 27,195 deaths and resulted in around 165,159 life years gained.

The majority of these ­ 47 per cent ­ came from secondary prevention, 30 per cent from treating angina and 11 per cent from treating


Study lead Dr Dogan Fidan, now a health technology analyst at the National Institute for Clinical Excellence, said 'barely half' of the patients in the study were receiving appropriate therapy such as statins or aspirin.

He said: 'NHS resources are scarce, yet substantial sums are being expended on costly interventions such as angioplasty and CABG surgery, with relatively poor returns.

'Several published studies have consistently suggested the most cost-effective interventions are population-based primary prevention, particularly diet and smoking ­ this merits debate.'

Dr Mike Kirby, a GP in Letchworth, Hertfordshire, and a member of the Primary Care Cardiovascular Society, said it was essential that every patient with CHD or at high risk of the condition was taking a statin.

'From the primary care point of view prevention is better than cure,' he added.

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