Cut-price statins are putting patients at risk, say doctors


Last updated at 22:00 01 March 2007

Four in ten GPs believe the safety of patients on cholesterol-lowering drugs is being jeopardised by Government pressure to prescribe cheaper tablets.

Their warning comes after a patient nearly died following a change to a less expensive statin.

Nearly all GPs surveyed said they were coming under pressure from primary care trusts to ease the Health Service's financial crisis by switching patients' treatment.

The Government has already advised trusts that the NHS could save £85million a year if more doctors prescribed generic versions of statins, instead of branded makes.

Currently the cost to the NHS of providing statins for two million patients is £600million a year. The cost-cutting drive is expected to widen to include generic ulcer drugs and non-branded aspirin, used to reduce blood-clotting.

But many GPs claim it is not safe for all patients to be transferred to cheaper options, as they may not be suitable for those with complicated conditions and could interact with other medication.

The survey carried out for GPs' newspaper Pulse showed 42 per cent of doctors said the drugswitching scheme in their area was "not consistent" with maintaining patient safety. And more than a third of 120 GPs questioned said the pressure had compromised their ability to take clinical decisions.

Yet 41 per cent of GPs said they were under a 'strong' amount of pressure to change their patients to cheaper drugs.

Dr Simon Cooke, a GP in Norwich, said he had "definite concerns about patient safety" after one suffered kidney failure when switched to a cheaper drug.

The kidney transplant patient, who was on immunosuppressants, recovered only after going back to the original statin.

Dr Cooke said: "Some of the prescribing advice that primary care trusts issue is farcical, too dogmatic and loses sight of the fact that, as a GP, I'm making a considered choice based on an individual patient."

Dr Jane Lockhart, a GP in Manchester, said such 'blanket' switch schemes "ride roughshod over the concept of individual attention to each patient and patient choice".

She added: "It is inevitable that when prices change we will be changing them all again, so potentially the patients will be exposed to those risks again and again."

Prices for a 28-day course of brand-name statins range between £18.03 and £29.69.

The same length course of a less potent, generic alternative - such as pravastatin and simvastatin - costs between £1.89 and £4.57.

The Government wants generic drugs to be used in two-thirds of cases - currently achieved by a quarter of trusts.

Yet doctors in North Staffordshire claimed twice as many heart patients were readmitted to hospital after an imposed change to generic drugs, with deaths trebling.

Jo Haynes, editor of Pulse, said "Given the financial climate, many trusts have little choice but to try to clamp down on drugs bills, but the issue is how they go about it.

"Some are finding efficiency savings in partnership with GPs, but others are issuing diktats about which drugs can be used that are wholly at odds with the freedom of doctors and needs of patients."

A Department of Health spokesman said: "Generic drugs are safe, of good quality and just as effective as branded drugs.

"We are aware, however, that there are circumstances in which generic prescribing may be inappropriate and we expect GPs to use their clinical judgment.

"There is nothing to prevent branded prescribing if a doctor considers it essential."

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