NZ Australia gap widening in cholesterol control

Recent audit confirms New Zealand and Australia gap widening in cholesterol control

April, 2007 Recent data from an audit commissioned by pharmaceutical company AstraZeneca of 6,901 heart patients has shown that New Zealand patients with recorded high cholesterol levels and on a cholesterol reducing agent (statins i ) are at least twice as likely to be poorly controlled versus their Australian counterparts.

Currently only 26% ii of New Zealanders treated with statins achieve the New Zealand National Heart Foundation recommended goal of Total Cholesterol (TC) <4mmol/L iii . This compares with 51% of Australians currently being treated with statins achieving the NHF Lipid Management Guideline lipid target of low-density lipoprotein (LDL) cholesterol <2.0mmol/L.iv

“In those who have angina or have survived a heart attack or a stroke, cholesterol levels need to be much lower than average levels in healthy New Zealanders,” says Christchurch Cardiologist Associate Professor John Elliott v .

“It is of great concern that only 26% of patients treated with a lipid lowering agent are reaching the national guideline goal, even more so when you consider that international guidelines are lower still vi ,” says Associate Professor Elliott. “We need an urgent change in the special authority criteria that currently restrict access to existing therapies as well as better access to newer effective therapies”.

Research has shown a direct relationship between the fall of LDL cholesterol and the reduction in cardiovascular (CV) risk. It has been proven that a reduction of 1% in LDL cholesterol level reduces the relative risk for major coronary heart disease events by approximately 1%vii .

However, cardiovascular disease remains the commonest single cause of death in New Zealand accounting for 40% of deaths annually viii . “Statins have revolutionised the prevention of heart attacks and strokes, peripheral vascular disease and death in other OECD countries” says Auckland Cardiologist Professor Harvey White.

“In New Zealand this preventative approach has been significantly hampered by limiting patient access to these medicines, and our guidelines need to catch up with International ones.”

The recent New Zealand Pharmaceutical Industry Taskforce (NZPIT) Submission on the Towards New Zealand Medicines Strategy Consultation Document confirmed that New Zealand’s effective statin consumption is lower than other OECD countries. New Zealand has never got close to Australia with regards to consumption of equivalent units of statins or indeed in ability to lower cholesterol. Furthermore, the gap between Australia and New Zealand is increasing.

The audit results show that there is currently an unmet medical need for cholesterol lowering agents in New Zealand. Australia’s higher level of control can be attributed to the availability of newer agents which reduce cholesterol levels in high risk patients at doses much lower than that required by the older statins.

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