Survey Shows 71% Of GPs Are Concerned That Financial Restrictions Are Hindering Best Practice In Cardiovascular Disease (CVD) Risk Management

Date: Jul-02-201263% of respondents have exception coded patients who failed to reach CVD targets on statins
alone despite alternative treatments being available

Despite government calls to stop commissioners blacklisting the use of
certain NICE, SIGN and SMC approved medicines, an MSD sponsored survey of over 450 UK GPs,
reveals the extent of local prescribing restrictions being placed on cholesterol-lowering medications.
Key survey findings:1
93% (n=422) have been told to switch a patient's dyslipidaemia medication to a cheaper
alternative
68% (n=100) of GPs feel frustrated by restrictions on their prescribing autonomy and 60%
(n=89) think cost is restricting best medical practice
Of the 63% (n=284) of GPs who have exception coded patients not reaching CVD targets with
statins alone, 42% (n=120) cited this as due to local prescribing restrictions or pressure from
local authorities
Of the reasons given for exception reporting CVD patients not reaching CVD targets, GPs
commonly cite patient intolerance to statins despite alternative types of cholesterol-reducing
medication being available
While generic statins are the first treatment of choice in cholesterol management, GPs have a range of
other (NICE/SMC/SIGN) approved medications which they may choose to prescribe to patients at high
risk of CVD or who have experienced tolerability issues with statins. However, the survey suggests that
many GPs are unable to prescribe these medications due to financial reasons and these restrictions
mean that some prescribers are unable to follow accepted national guidelines.

Lipidologist Dr Dermot Neely, Co-chair of HEART UK's Familial Hypercholesterolemia (FH) Guideline
Implementation Team, expressed concern at the findings of the recent research; "Prescribing
restrictions for high intensity lipid-lowering medication in CVD could be putting a significant number of
our patients at unnecessary risk. FH is a condition comparable to Type 1 diabetes and, unless treated
to optimal low-density lipoprotein (LDL) cholesterol targets, people with FH could suffer the sort of
premature arterial damage we see in people with Type 1 diabetes with poor glycaemic control. It is hard
to imagine people with Type 1 diabetes being denied the insulins they need in the way that FH patients
are being denied access to the specialist care and lipid-lowering medications recommended by the
current NICE clinical guidelines."

A particular example of a cholesterol-lowering medicine to which access is being restricted is Ezetrol
(ezetimibe). Despite the drug being NICE, SMC and SIGN approved, 68% (n=306) of surveyed GPs
said that they had experienced restrictions in its prescribing, with 76% (n=234) of these GPs believing
this is due to financial restrictions in their area.1 Tellingly, when asked whether they would prescribe
ezetimibe more widely if there were no such restrictions, 71% (n=321) of GPs confirmed that they
would, with 70% (n=225) of those saying it would be in high-risk or hard-to-treat patients.1

The results of the survey are even more significant in light of recent British Heart Foundation data
which showed that a third of patients prescribed statins do not take their medication.2 Access to a wide
range of appropriate treatment can help play an important role in the reduction of cardiovascular
disease in the primary care setting, and in the prevention of significantly more expensive treatment of a
vascular event in secondary care.

Courtesy: Medical News Today Note: Any medical information available in this news section is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional.