Updates from the National Health Service
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About 300,000 people in England will be offered an injection twice a year to treat high cholesterol under an agreement between pharmaceutical giant Novartis and the heavy NHS, while the health service seeks to prevent heart disease, the world’s biggest killer rather than simply treating it.
Patients with high cholesterol and a history of cardiovascular disease are selected to receive the treatment, known as incisiran, for the next three years.
NHS England, which called the deal its first ‘population health deal’, said the drug could eventually be offered to half a million people, potentially preventing some 55,000 heart attacks and strokes and saving 30,000 lives within the next decade.
More than 40 per cent of the population in England have high cholesterol, which increases the risk of developing heart disease. About 6.5 million adults in England are prescribed lipid-lowering drugs, such as statins. The need to continue to take the medicine, even if a patient feels well, means that many people stop taking the medicine, which poorly controls their risks.
Amanda Pritchard, newly appointed head of NHS England, said the ‘world-leading agreement’ would enable hundreds of thousands to benefit from a ‘revolutionary’ treatment, which can be given by nurses in GP surgeries, and it is not necessary to go to hospital.
Publicly available datasets will be used to identify the areas with the worst outcomes for cardiovascular disease so that the new treatment can be offered to patients who benefit most from better cholesterol control.
Meanwhile, digital tools are being developed to examine patient records and identify patients whose cholesterol is not well managed so that GPs can review their care and determine if they are candidates for inclisiran.
Sir John Bell, professor of medicine at the University of Oxford and a leading architect of the government’s life science strategy, said the NHS ‘decision to purchase the treatment on a very large scale shows the growing importance of prevention to keep the cost of healthcare low.
“If we enter a post-Covid world where services are under great pressure, the sustainability of the whole system will be called into question if it does not move to a more prevention-oriented strategy,” he said.
The pharmaceutical industry has regularly criticized the slow use of innovative medicines in the UK compared to its peers. Even if a drug is approved by the National Institute for Health and Care Excellence, which determines whether a drug is cost-effective, there is no certainty that it will be widely accepted in the health system.
Bell said the benefit of the inclisiran agreement for Novartis was that it has a guaranteed market for its medicine. “The muscle of a single payer system is extremely attractive to the industry because they do not have to negotiate a million transactions and spend a lot of money on marketing,” he said.
Marie-France Tschudin, president of Novartis Pharmaceuticals, said the project showed that the UK could take the lead and make it “an attractive place for research and innovation”.
She added that the agreement provides a ‘blueprint’ that can be used for other medicines, such as treatments for diabetes. ‘There are other disease areas where you see a very, very high number of patients, and where it can possibly be prevented. . . why should we not take a more proactive approach? ”
Novartis is already in talks with 15 other countries – and the top 200 healthcare systems in the US – to do similar transactions for inclisiran.
“This disease is a huge burden, not only for patients and their families, but also for society and the healthcare systems themselves,” she said.