* NICE recommends halving risk threshold for taking statins
* Backs drug use when 10 percent heart risk over 10 years
* Cheap generics make statins cost-effective option
By Ben Hirschler
LONDON, Feb 12 (Reuters) - Doctors should use cholesterol-lowering statin drugs much more widely to prevent heart attacks and strokes, according to Britain’s healthcare cost-effectiveness watchdog.
In a major revision to 2008 guidelines, the National Institute for Health and Care Excellence (NICE) recommends the threshold for starting on statins should be halved from a 20 percent risk of developing cardiovascular disease over 10 years to a 10 percent risk.
An estimated 7 million people in Britain already take statins at an annual cost of around 450 million pounds ($738 million), and reducing the benchmark for treatment would increase that number significantly.
But increased use is viewed as a cost-effective strategy, since cardiovascular disease in England alone cost the state-run National Health Service (NHS) some 7.88 billion pounds in 2010.
NICE said on Wednesday its new draft guidance, which is subject to consultation, reflected the latest medical evidence on heart risks as well as a fall in the prices of many statins in recent years thanks to generic competition.
The agency assesses both cost and clinical effectiveness in determining whether treatments are worth using on the NHS.
“The effectiveness of these medicines is now well proven and their cost has fallen,” said Mark Baker, director of the Centre for Clinical Practice at NICE.
Baker said people with high cholesterol also needed to eat less saturated fat and sugar, exercise more, lose weight and stop smoking.
The NICE proposals echo new U.S. guidelines on heart health that recommend more aggressive statin therapy for high-risk patients.
NICE said the preferred drug for patients starting on statin therapy was atorvastatin, the chemical name for Pfizer’s popular Lipitor, which is now available as a cheaper generic.
Most statins are now off patent and available as generics, although Britain’s AstraZeneca still has exclusivity on Crestor, a particularly potent statin and the company’s top-selling medicine.
Better drugs and prevention strategies such as anti-smoking campaigns have slashed death rates from cardiovascular disease in recent decades.
In Europe, the death rate from cardiovascular disease has been halved over the past 30 years, while the risk of dying within 30 days of a heart attack has been cut by more than half in just 20 years.
Yet cardiovascular disease remains the number one killer in Britain and worldwide, and many doctors fear a renewed epidemic of heart problems in 20 to 30 years as a new generation of overweight and obese youngsters reaches middle age.