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 In a major revision to 2008 guidelines, the National
Institute for Health and Care Excellence (NICE) recommends the
threshold for starting on statins should be halved from a 20 percent
risk of developing cardiovascular disease over 10 years to a 10
percent risk.
An estimated 7 million people in Britain already take statins at an
annual cost of around 450 million pounds ($738 million), and
reducing the benchmark for treatment would increase that number
significantly.
But increased use is viewed as a cost-effective strategy, since
cardiovascular disease in England alone cost the state-run National
Health Service (NHS) some 7.88 billion pounds in 2010.
NICE said on Wednesday its new draft guidance, which is subject to
consultation, reflected the latest medical evidence on heart risks
as well as a fall in the prices of many statins in recent years
thanks to generic competition.
 The agency assesses both cost and clinical effectiveness in
determining whether treatments are worth using on the NHS.
"The effectiveness of these medicines is now well proven and their
cost has fallen," said Mark Baker, director of the Centre for
Clinical Practice at NICE.
Baker said people with high cholesterol also needed to eat less
saturated fat and sugar, exercise more, lose weight and stop
smoking.
The NICE proposals echo new U.S. guidelines on heart health that
recommend more aggressive statin therapy for high-risk patients.
NICE said the preferred drug for patients starting on statin therapy
was atorvastatin, the chemical name for Pfizer's popular Lipitor,
which is now available as a cheaper generic.
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Most statins are now off patent and available as generics,
although Britain's AstraZeneca still has exclusivity on Crestor, a
particularly potent statin and the company's top-selling medicine.
Better drugs and prevention strategies such as anti-smoking
campaigns have slashed death rates from cardiovascular disease in
recent decades.
In Europe, the death rate from cardiovascular disease has been
halved over the past 30 years, while the risk of dying within 30
days of a heart attack has been cut by more than half in just 20
years.
Yet cardiovascular disease remains the number one killer in Britain
and worldwide, and many doctors fear a renewed epidemic of heart
problems in 20 to 30 years as a new generation of overweight and
obese youngsters reaches middle age.
($1 = 0.6098 British pounds)
(Editing by Jane Baird)
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