Impact of a policy allowing for over-the-counter statins

Mainous, Arch G III PhD
Baker, Richard MD
Everett, Charles J PhD
King, Dana E MD MS

Professor, Department of Family Medicine, Medical University of South Carolina, Charleston, USA and Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, USA
Professor, Department of Health Sciences, University of Leicester, Leicester, UK
Research Associate
Professor
Department of Family Medicine, Medical University of South Carolina, Charleston, USA

FUNDING

This work was supported in part by a grant from the Blue Cross and Blue Shield Foundation of South Carolina.

ETHICAL APPROVAL

This study was approved by the Medical University of South Carolina Independent Review Board.

PEER REVIEW

Not commissioned; externally peer reviewed.

CONFLICTS OF INTEREST

None.

ADDRESS FOR CORRESPONDENCE

Arch G Mainous III, Department of Family Medicine, Medical University of South Carolina, 295 Calhoun Street, Charleston, SC 29425, USA. Tel: 001 843–792–6986; fax: 001 843–792–3598; email: [email protected]

Received 4 May 2010

Accepted 22 August 2010

Quality in Primary Care 18(5):p 301-305, 2010.

Background

Allowing statins to be sold without a prescription has been widely debated in Great Britain, Canada and the USA.

Aims

To examine the impact of the recent policy in Great Britain allowing patients to purchase over-the-counter (OTC) 10 mg dose of a cholesterol-lowering drug (simvastatin) on meeting the needs of individuals at moderate risk of coronary heart disease (CHD).

Methods

We undertook an analysis of adults (aged >20 years) in the nationally representative 2006 Health Survey for England (HSE, n =10 007). We evaluated the proportion of individuals using OTC statins among all adults aged 20 years and over and among individuals eligible for them according to current guidelines.

Results

Among adults in the HSE, 44.1% met the criteria for referral to a general practitioner for CHD risk, 9.7% were eligible for OTC statins and 46.1% did not meet the eligibility for prescribed or OTC statin therapy. Less than 1% (0.7%) were taking OTC statins. The proportion of individuals using OTC statins among those eligible for them was low and comparable to that in the overall population (0.2%). Among those taking OTC statins, 71.5% were also taking prescribed lipid lowering agents.

Conclusion

These results suggest that the aim of addressing the treatment gap among individuals at moderate risk by offering access to OTC statins has not been achieved two years after the implementation of the policy.