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Ezetrol receives NICE approval

Published on 30/11/07 at 12:42pm

NICE has approved Ezetrol, the cholesterol-lowering drug marketed by MSD and Schering-Plough.

Data shows the drug significantly reduces bad cholesterol when taken alongside generic simvastatin, and the guidance could see fewer patients switched to more potent statins to reach their target cholesterol level.

Ezetrol (ezetimibe) lowers cholesterol by inhibiting its absorption in the gut, whereas statins reduce bad cholesterol by reducing its production in the liver.

NICE was presented with clinical data showing the combination reduced bad cholesterol by 23% more than statins alone, and its appraisal found the use of simvastatin and Ezetrol a cost-effective option for the NHS.

The cost of 28 tablets of generic simvastin (40-mg) is £1.31. Prescribed along with 28 tablets of Ezetrol at £26.31, the treatment totals £27.62.

The price for 28 tablets of the 40-mg strength of the more potent statin Lipitor (atorvastatin) is £28.21.

If Ezetrol/simvastatin is prescribed to half a million patients instead of Lipitor, the saving is significant, though there is some discrepancy, as the average starting dose of Lipitor is less than 40-mg.

Dr Clive Weston, a cardiologist based in Swansea, has worked with MSD Shering-Plough in talking about the benefits of Ezetrol.

He predicts an increase in prescriptions of simvastatin following the new guidance, as it will allow GPs to meet both rising national targets for the prescription of generic statins and the needs of their patients.

But he also believes some doctors will remain loyal to more potent statins, and avoid using Ezetrol.

He said: "It is the first time the NICE guidance committee have bought into the opinion that it doesn't matter how you lower LDL (bad cholesterol), as long as it is reduced. And Ezetrol certainly does that.

"But there will be a group of clinicians that will stick to more potent statins, as they believe they are special due to their other qualities."

These include proof they reduce rates of heart attack and stroke.

No clinical data has demonstrated Ezetrol does the same - it can only be assumed as a result of lowering cholesterol.

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