Will two injections a year lower my cholesterol?

Residents of England and Wales will soon have access to an expensive but highly effective cholesterol-lowering drug. And it will be available free of charge through the National Health Service (NHS).

The National Health Service estimates that the new drug Incliciran, if administered to patients twice a year, could save approximately 30,000 lives over the course of a decade. The drug (sold under the brand name Leqvio) costs around 2000 pounds (2750 dollars) per dose, but the company that makes it, Novartis, has agreed to supply it with a discount, the size of which is undisclosed.

The preliminary draft guidance from the National Institute for Health and Care Excellence (NICE) states that inclisiran reduces levels of bad cholesterol in the blood when other, cheaper drugs, such as statins, do not work or are not effective enough. NICE, a certifying body for drugs in England and Wales, recommends it as an option for people who have had a stroke or heart attack and have not been helped by other cholesterol-lowering drugs. Experts hope this will help reduce the risk of other life-threatening cardiovascular problems. While there is currently no evidence of the long-term effectiveness of the drug, doctors believe that it can be used on the basis of the existing data. In Scotland, where there is a separate medicines certification agency, inclisiran was recommended for limited use in August.

The NICE recommendations state that injections of inclisiran should be administered by a nurse, for example in a general practitioner’s practice.

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If the widely used statins slow down cholesterol production in the liver, Inclisiran works in a different way: it stimulates the liver to remove harmful cholesterol. Inclizeran inhibits or suppresses the PCSK9 gene, causing the liver to take up more “bad” low-density cholesterol from the blood and break it down. This medicine may be used with statins. “Inclisiran has the potential to be a game-changer in preventing premature deaths from heart attack and stroke for thousands of people,” said Meindert Boysen, Deputy Chief Executive of NICE and Director of the Centre for Health Technology Evaluation. “We are therefore pleased to be able to recommend it for use by the National Health Service.”

“Cardiovascular disease remains a major cause of death, so it is wonderful that we now have such an effective and convenient drug for people with dangerously high cholesterol,” said Amanda Pritchard, CEO of the National Health Service. “The introduction of Inclisiran will save many lives while being fair to the taxpayer. The British National Health Service is funded directly from the national budget. Everyone living in the United Kingdom has access to free health care. Prescription drugs are dispensed free of charge at pharmacies in England, except for a fixed charge of £9.35 per prescription.”

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