Switching statins: NICE tool overestimates benefits of statins

doi:10.1136/bmj.332.7556.1512-b

BMJ 2006;332:1512-1513 (24 June), doi:10.1136/bmj.332.7556.1512-b

Letter

Switching statins

NICE tool overestimates benefits of statins

The first 150 words of the full text of this article appear below.

EDITOR—Moon and Bogle should be supported in their callto move from branded to generic statins.¹ However, by usingthe costing tool of the National Institute for Health and ClinicalExcellence (NICE),² they have probably overestimated the benefitsof statins.

The 10 year risk thresholds for cardiovascular disease for startinga statin in primary prevention have recently been reduced from40% to 20%.^{2 3} The NICE tool models the impact of this changeby adding together the effect of statins on a range of cardiovascularevents by using trial findings for fatal and non-fatal myocardialinfarction, angina, transient ischaemic attack, and stroke.I have tested this approach by comparing the results of theNICE tool with a new analysis of Scottish health survey 1998data.⁴

When population figures for Lothian, Scotland (population 779000) are used, the NICE tool estimates that 23 648 additionalpeople would receive statins with . . . [Full text of this article]

D Graham Mackenzie, specialist registrar in public health

Public Health Department, NHS Fife, Windygates, Fife KY8 5RG gm@nhs.net