Statins can help prevent coronary heart disease in people whose annual risk is 0.6% or more. Yet this would lead to treatment of over 40% of the British adult population, and would be unaffordable under the NHS.

Current medical practice therefore recommends treatment only for those with a risk of over 3% a year, but this denies effective treatment to 32% of the adult population.

However, if patients who are currently ineligible for statins were told that they could benefit from these drugs, some might be willing to pay for a private prescription, suggest GP, Nick Raithatha and health economist, Richard Smith.

They predict that the cost of private treatment with monitoring by an NHS practice nurse would eventually be 93.66 a year. This is far less than average household expenditure on, for example, alcohol (320), clothes (380) and motoring (920), and may therefore be quite affordable to people on average earnings.

Although private prescriptions would increase inequality in access to health care, this is a form of inequality whereby all members of society gain and is therefore both economically and ethically jusifiable, they conclude.

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Contact: Emma Dickinson
edickinson@bmj.com
44-20-7383-6529
BMJ-British Medical Journal
12-Feb-2004