High dose statins could be made available directly from high street pharmacies as part of the NHS Long Term Plan to cut heart disease and stroke, NHS chief executive Simon Stevens has announced.

In a new review confirmed today, England’s top pharmacist Dr Keith Ridge and newly-appointed director of primary care, Dr. Nikki Kanani, will look at how the cholesterol-busting drugs could be provided by high street chemists.

Although low dose statins can be given over the counter, they are not generally made available by pharmaceutical firms, and making the most effective and powerful versions safely available, without a doctor’s prescription, could prevent thousands more deaths and countless more heart attacks and strokes.

Benefits of statins are potentially even higher than previously reported

It’s estimated that as many as two-thirds of people most at risk of heart attack and stroke do not take statins, but would benefit from doing so. Statins have been shown to be effective, with minimal side-effects, and even a small reduction in cholesterol from these drugs is able to save lives.

New research from Cambridge University – and funded by the British Heart Foundation – published at the European Society of Cardiology Conference in Paris this week, has shown that the benefits of statins are potentially even higher than previously reported.

The findings of the NHS England and Improvement review will be presented to manufacturers and the Medicines and Healthcare products Regulatory Agency (MHRA) – the medicines watchdog – which would have the final say.

Speaking at the Expo health and care innovation conference in Manchester NHS chief executive Simon Stevens said: “Pharmacists are highly trained health professionals who are greatly valued by patients. Since the NHS will be funding local chemists to undertake health checks, it makes sense to consider whether there are a broader range of medicines that patients could access conveniently and locally on the high street. So the NHS will now work with the MHRA and industry to see how we can best make this happen.

“After cancer lung scanning trucks in supermarket carparks and High Street heart checks, this is another step towards making care and treatment more accessible, convenient and effective.”

"Used appropriately, statins are effective and can save lives"

The NHS Long Term Plan, published earlier this year, said that local NHS teams will actively identify and support more people living with high cholesterol who could benefit from statins, rolling out care to as many as 380,000 more people, supported by nationwide primary care networks. 

Chief Pharmaceutical Officer Dr Keith Ridge said: “Used appropriately, statins are effective and can save lives. Hundreds of thousands of people could benefit if industry committed more research and investment in bringing high-dose statins to the high street, and the NHS is going to be driving forward these efforts, as we save thousands of lives from deadly heart attacks and strokes as part of our Long Term Plan.

The Royal College of General Practitioners (RCGP) said, however, that the plans to make statins available over-the-counter should be approached with caution. Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said that although extensive medical evidence has shown that statins are usually a safe and effective preventative measure against heart disease, GPs are also mindful of the risks of overdiagnosis and over-treatment.

She added: "This is a concern we expressed in response to recent NICE guidelines that lowered the threshold for eligibility of statins – and we also have concerns about making these drugs more easily accessible, without a prescription. Statins, like any medication, have associated risks, and GPs will only prescribe them if we think it is in the best interests of an individual patients, based on their individual circumstances – and after a frank conversation about the potential risks and benefits.

“Nevertheless, it is encouraging that NHS England are conducting this review before implementing a new initiative, and the College looks forward to feeding into it. Prevention is important, but it is essential that any NHS intervention to promote it is evidence-based, and in the best interests of patients.”