Two thirds of GPs are refusing to comply with controversial NHS advice to prescribe statins to millions more adults, polling has found.
Family doctors said guidelines from the National Institute for Health and Care Excellence (Nice), advising 40 per cent of adults to take the pills, were “simplistic”. They insisted they would not allow the “mass medicalisation” of the public.
The guidelines, published in July, say drugs to protect against strokes and heart attacks should be offered to anyone with a one in 10 chance of developing heart disease within a decade.
It means 17.5 million adults, including most men aged over 60 and women over 65, are now eligible for the drugs, which cost less than 10p a day.
A number of cardiologists have defended the guidance, which Nice says could cut 50,000 deaths a year from strokes and heart attacks.
But the advice has divided experts, with prominent doctors accusing Nice’s experts of being too close to the pharmaceutical industry.
The survey of 560 GPs, carried out by Pulse magazine, found 66 per cent of family doctors say they are not complying with the guidance. The system of pay for family doctors means part of their income depends on how far they comply with guidelines on prescribing, including the Nice advice on statins.
Many of the GPs said they were not prepared to be “bribed” to put more patients on the drugs, with others saying the recent advice was “bonkers,” and “simplistic”. “You won’t bribe me with payments to hit statin targets,” said Dr Sanjeev Juneja, a GP from Rochester, Kent. “I have seen havoc caused in some patients with this drug, so Nice pressure is not so nice.”
Dr Richard Vautrey, deputy chairman of the British Medical Association, said: “This is something that an awful lot of GPs have concerns about, and they simply aren’t prepared to prescribe drugs in such a broad way, when the evidence supporting this approach isn’t clear.”
Arguments have raged about the side effects of statins. In May the British Medical Journal withdrew statements which had said that one in five of those on the drugs suffered from ill-effects such as muscle pain, tiredness and diabetes, saying the claims were wrong.
But some doctors believe such problems have been under-reported.
Dr May Cahill, a GP partner in Hackney, east London, said she was not convinced of the benefits of prescribing drugs with “horrific” sideeffects. She said: “Why give something to a patient that you would not take yourself nor recommend a family member or friend to?”
Dr Andrew Green, chairman of the BMA’s clinical and prescribing subcommittee for GPs, said no doctor should automatically prescribe the drugs based on a “slavish devotion” to advice from Nice.
Until July, GPs were advised to offer statins to anyone with a one in five chance of heart disease within a decade. The new advice halves the threshold to one in 10.
Even before that change, Britain was the “statins” capital of Europe, with the second-highest prescribing levels in the Western world for the drugs. A study last by year by the Organisation for Economic Cooperation and Development, which examined 23 industrialised nations, found this country had the highest levels of statins use in Europe, with 13 per cent of adults taking the pills daily.
Dr Aseem Malhotra, a London cardiologist who has been critical of the Nice guidance, said: "Although it is clear that the benefits of statins outweigh harms in those who have suffered a heart attack and are at high risk, this is in my view is not the case in a healthy population, where it does not reduce the risk of death.
"I am pleased to see that the majority of GPs are also realising this and acting upon it."
http://www.telegraph.co.uk/
I can't get the full story with this next link but you can draw conclusions from this short extract.
On Oct 21, a group of public health scientists and medical political leaders wrote to Sarah Wollaston, Chair of the UK House of Commons Health Select Committee, to call for an independent investigation into the National Institute for Health and Care Excellence (NICE). The letter's nine authors included Kailash Chand (Deputy Chair of the British Medical Association's Council), Lord Ian McColl, and Professor Simon Capewell. The charges were serious, and related to what they characterised as NICE's ...
http://www.thelancet.com/
Doctors having a pop at the NHS and NICE wonder what Sid Bonkers thinks about this.
Graham
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