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The great statin debate

Statins are one of the most talked about classes of drug in medical history and there's no sign of the debate quietening down any time soon.

Statins are one of the most talked about classes of drug in medical history and there's no sign of the debate quietening down any time soon.

It's not that there's real doubt over the drugs' effectiveness – it's precisely because they can work so well that there's so much discussion over how widely they should be used.

As far as cardiologists and apparently ministers are concerned, the answer appears to be very widely indeed.

This week Pulse reveals almost half of all patients over 40 will be eligible for statins when screened under recommendations included in JBS2 and SIGN guidance, and set to form the basis of a national screening programme for cardiovascular risk.

Mass medicalisation fears

GPs are desperately concerned over the impact this mass medicalisation will have on workload and on their patients. There are also worries over the trend to shift decisions on how to treat individual patients from GPs to national policymakers.

As GPs well know, policymakers don't always get it right. Only this week, we learned two PCTs are reviewing another policy on statins – the mass switch from atorvastatin to simvastatin – after an audit found the scheme could be costing lives.

Both statin use for primary prevention and switching schemes have their place in an NHS looking for the most cost-effective means of maintaining health.

But GPs must be allowed to use their judgment in deciding when to use a statin and which it should be. Policies come and go but the principles of good, personal care must remain.

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