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Continued access to two cholesterol drugs

Media release

Patients to have continued access to two cholesterol drugs

PHARMAC is responding to the advice of expert clinicians in providing people with continued fully subsidised access two cholesterol-lowering statins drugs.

From 1 June 2004, PHARMAC will pay the same subsidy for atorvastatin (Lipitor) as it does for simvastatin (Lipex/Zocor).

During consultation, clinicians indicated they considered there was a clinical need for some patients to have continued access to the higher doses of atorvastatin.

PHARMAC’s response has been to allow those people taking 40mg of atorvastatin and above to continue doing so under full subsidy, and to allow those people who are unable to tolerate simvastatin to be able to also have atorvastatin fully funded. Meanwhile, PHARMAC is continuing to work constructively with Pfizer, to ensure the continued supply of atorvastatin at current prices.

PHARMAC’s medical director Dr Peter Moodie says the two drugs have the same action, and are generally well tolerated. Both are effective at reducing cholesterol, a risk factor for cardiovascular disease.

Already about 140,000 New Zealanders are taking simvastatin to help control their cholesterol levels, and this is likely to keep increasing.

Atorvastatin will continue to be targeted at those patients whose cholesterol levels have not reached agreed targets through using simvastatin, and to those patients unable to tolerate simvastatin.

“For most people changing medicine will present no problem,” says Dr Moodie. “However, issues have been raised by expert clinicians who consider there is a need for some people to have a fully funded alternative to simvastatin.”

“For that reason, we’re allowing those people taking the higher doses of atorvastatin to continue to do so. In addition, those people who are unable to tolerate simvastatin, or who have been unable to adequately control their cholesterol with it, will also be able to take atorvastatin.”

The reference pricing will mean that a minimum of $18 million will be able to be redirected into funding other medicines over the next five years.

Dr Moodie says there is good evidence around the effectiveness of statins, particularly simvastatin which is supported by long-term evidence from large clinical trials.

“Historically, these drugs have not been prescribed enough,” Dr Moodie adds. “Less than half the eligible people were taking them, and those who have been missing out have often been those with high need. The latest data we have shows that about 57 percent of eligible people are currently receiving statins, so although the uptake rate has improved, there is still over 100,000 people who are missing out.”

PHARMAC has been running pilots of a campaign, One Heart Many Lives, which encourages the use of statins as part of overall cardiovascular risk management.

Note: Background information attached

Background information on access to two cholesterol drugs

- Simvastatin (Lipex/Zocor) and atorvastatin (Lipitor) will continue to be listed on the Pharmaceutical Schedule
- Simvastatin is able to be prescribed according to published guidelines
- Patients on a dose of 40mg and above atorvastatin before 1 April 2004 will be able to keep using it under full subsidy.
- Atorvastatin will be available to other patients unable to tolerate simvastatin, or who do not reach target cholesterol levels when treated with it
- The decision will create at least $18 million in savings over five years, to spend on other medicines
- Implementation from 1 June 2004
- Information will be provided to doctors and pharmacists.

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